[31F] Experiencing painful urination, back pain, and itchy skin

Patient Description

A 31-year-old female presents with a 10-day history of painful urination, characterized by sharp pain at the end of urination and blood in the urine, also noted at the end. The patient reports cloudy urine despite adequate fluid intake. She has experienced back and flank pain, frequent urination, and some nausea associated with the pain but no vomiting. Additionally, she has itchy skin on her stomach and back, which has been present for approximately 5 days and results in a rash after scratching. The patient has been using lotion for relief. She passed what may have been stones or blood clots in her urine 5 days ago. There is no family history of kidney stones or disease. The patient's medical history is notable for an allergy to sulfa drugs. Current medications include Flomax (0.4mg once at night for 10 days), Cefdinir (300mg twice a day, started yesterday), and Azo. No other symptoms or health issues were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the most likely diagnoses include:

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain when passing through the urinary tract. Your symptoms of back and flank pain, frequent urination, and blood in the urine are common symptoms of kidney stones. The fact that you passed what you believe to be stones or blood clots in your urine also supports this diagnosis.

    • Treatment often involves pain relievers and drinking lots of water to help flush the stones out of your system. In some cases, medical procedures may be necessary to remove or break up larger stones.
  • Urinary Tract Infection (UTI): This is an infection in any part of your urinary system, which includes your kidneys, bladder, ureters, and urethra. UTIs can cause painful urination and cloudy urine, both of which you've reported. However, you mentioned that you've been tested for infections and the results were negative, which makes this less likely.

    • Treatment typically involves antibiotics to kill the bacteria causing the infection.
  • Drug Reaction: Some medications can cause itchy skin or a rash. Cefdinir, one of the medications you're taking, is known to cause these side effects in some people.

    • Treatment would involve stopping the medication and managing the symptoms. However, you should not stop taking your medication without first consulting your doctor.

Please note that while these are the most likely explanations based on your symptoms, they are not the only possibilities. Other conditions could also cause similar symptoms.

What you can do

  1. Continue to drink plenty of water to help flush out the kidney stones.
  2. Apply a moisturizer or over-the-counter hydrocortisone cream to your itchy skin to help relieve the itchiness.
  3. Avoid scratching your skin as much as possible to prevent further irritation or damage.
  4. Continue taking your medications as prescribed, but contact your doctor if you believe one of them might be causing your itchy skin.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable.
  • You develop a fever or chills, which could indicate an infection.
  • You start to feel very sick or your symptoms worsen significantly.
  • You are unable to pass urine or your urine becomes very dark or smelly.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


What are the common symptoms of kidney stones?

Common symptoms of kidney stones include severe pain in the back and side, pain during urination, blood in the urine, cloudy or foul-smelling urine, nausea, and frequent urination.


Can a urinary tract infection cause blood in the urine?

Yes, a urinary tract infection can cause blood in the urine, along with symptoms like painful urination, frequent urination, and cloudy urine.


What should I do if I suspect a medication is causing a rash?

If you suspect a medication is causing a rash, you should contact your doctor immediately. Do not stop taking the medication without consulting your healthcare provider, as they may need to prescribe an alternative or provide treatment for the rash.


How can I differentiate between a kidney stone and a urinary tract infection?

Kidney stones often cause severe pain in the back or side, especially when passing through the urinary tract, and may cause blood in the urine. A urinary tract infection typically causes painful urination, frequent urination, and may also cause cloudy urine. A healthcare provider can perform tests to accurately diagnose the condition.


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