[30F] Experiencing pelvic pain and persistent tongue coating

Patient Description

A 30-year-old female has been experiencing intermittent pelvic pain rated 4/10 for approximately one year, initially associated with fever. The pain was intense at onset and partially relieved by antibiotics for Pelvic Inflammatory Disease (PID), but did not completely resolve. She also reported more painful periods and spotting at the onset of symptoms, which have since normalized. Additionally, she has a persistent bothersome coating on her tongue, more pronounced towards the back, which has not improved with scraping or brushing. She was diagnosed with Gardnerella following the onset of symptoms after engaging in unprotected sex with a new partner. The patient has no known pre-existing conditions, allergies, or adverse reactions to medications and is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs. It's often caused by sexually transmitted bacteria. Symptoms can include pelvic pain, abnormal vaginal discharge, and fever. You mentioned that your symptoms improved with antibiotics for PID but did not completely resolve, which suggests this could be a chronic or recurring issue.

    • Treatment typically involves antibiotics. In some cases, hospitalization or surgery may be necessary.
  • Bacterial Vaginosis (BV): This is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina. You mentioned a diagnosis of Gardnerella, which is commonly associated with BV. Symptoms can include a thin, gray, white or green vaginal discharge, and pain, itching or burning in the vagina.

    • Treatment typically involves antibiotics.
  • Oral Hairy Leukoplakia: This is a condition caused by the Epstein-Barr virus. It can cause white patches on the tongue that can't be scraped off. It's often seen in people with weakened immune systems, such as those with HIV/AIDS.

    • Treatment typically involves antiviral medications.

Please note that these are potential diagnoses based on the information you provided. It's important to consult with a healthcare professional for an accurate diagnosis and treatment.

What you can do

  1. Schedule an appointment with a healthcare provider. They can perform tests to confirm a diagnosis and prescribe appropriate treatment.
  2. Practice safe sex. Use condoms to reduce your risk of sexually transmitted infections.
  3. Maintain good oral hygiene. Brush your teeth twice a day and clean your tongue regularly.

What you should look out for

  • Severe pelvic pain or heavy bleeding
  • Fever or chills
  • Severe oral pain or difficulty swallowing

If you experience any of these symptoms, seek medical attention immediately.

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10 mo ago

People Also Ask


What are the common symptoms of Pelvic Inflammatory Disease (PID)?

Common symptoms of PID include pelvic pain, abnormal vaginal discharge, fever, painful urination, and pain during intercourse. Some women may also experience irregular menstrual bleeding.


How is Bacterial Vaginosis (BV) diagnosed and treated?

Bacterial Vaginosis is typically diagnosed through a pelvic exam and testing of vaginal discharge. Treatment usually involves antibiotics, such as metronidazole or clindamycin, to restore the normal balance of bacteria in the vagina.


What causes a persistent coating on the tongue that doesn't improve with brushing?

A persistent coating on the tongue that doesn't improve with brushing could be due to Oral Hairy Leukoplakia, which is often caused by the Epstein-Barr virus. It can also be related to other conditions like oral thrush or poor oral hygiene. A healthcare provider can help determine the cause.


How can I reduce the risk of sexually transmitted infections (STIs)?

To reduce the risk of STIs, practice safe sex by using condoms consistently and correctly, limit the number of sexual partners, and get regular STI screenings. It's also important to communicate with partners about STI testing and prevention.


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