[32F] Experiencing hematuria, joint pain, and systemic symptoms

Patient Description

A 32-year-old female presents with blood in urine that is most noticeable in the morning, having started 4 days ago. This is not the first occurrence of hematuria for the patient. She also reports aching and swollen joints in the wrists, ankles, and knees, with the pain beginning 3 days ago and rated at a severity of 5 out of 10. The patient experiences a throbbing headache and has noted confusion and feverish feelings. She has a history of unprotected sexual activity and has been informed by a hospital that a urinary tract infection is unlikely but a sexually transmitted infection may be possible. The patient has a medical history of scoliosis and fibromyalgia, diagnosed 8 years ago, and an allergy to Doxycycline. She is not currently on any medications.

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Arora's Assessment

What might be happening

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

  • Urinary Tract Infection (UTI): Despite the hospital's initial assessment, your symptoms of painful urination, blood in urine, and dark, smelly urine could still indicate a UTI. UTIs can sometimes be missed on initial testing.

    • Treatment typically involves antibiotics to clear the infection. Drinking plenty of water can also help flush bacteria out of your urinary system.
  • Sexually Transmitted Infection (STI): Given your recent unprotected sexual activity, some STIs can cause urinary symptoms and joint pain. For example, gonorrhea and chlamydia can cause these symptoms.

    • Treatment typically involves antibiotics. It's also important to notify any sexual partners so they can get tested and treated if necessary.
  • Kidney Stones: These can cause blood in the urine, back and abdominal pain, and sometimes fever. However, they don't typically cause joint pain.

    • Treatment can range from pain management and drinking lots of water to medical procedures.
  • Systemic Lupus Erythematosus (SLE): This is an autoimmune disease that can cause a wide range of symptoms, including joint pain, blood in urine, and confusion. However, it would be unusual for SLE to present this acutely.

    • Treatment typically involves managing symptoms and preventing flare-ups with medication.

Please note that these are possibilities based on the symptoms you've described, and not a definitive diagnosis.

What you can do

Since you're experiencing multiple symptoms, it's important to seek medical attention. Here are some steps you can take:

  1. Consult a healthcare professional: They can conduct a thorough examination and order appropriate tests to determine the cause of your symptoms.

  2. Stay hydrated: This can help with your urinary symptoms and general wellbeing.

  3. Rest: This can help your body recover and may alleviate some of your symptoms.

  4. Over-the-counter pain relief: Non-prescription pain relievers may help with your joint pain and headache. However, always follow the instructions on the package.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or you develop new symptoms
  • You experience severe abdominal or back pain
  • You have a high fever or your confusion worsens
  • You have difficulty urinating or the blood in your urine increases

Remember, while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common symptoms of a sexually transmitted infection (STI)?

Common symptoms of an STI can include unusual discharge from the genitals, pain during urination, sores or bumps on the genitals, and sometimes joint pain or swelling. It's important to get tested if you suspect an STI.


Can joint pain be related to urinary symptoms?

Yes, joint pain can be related to urinary symptoms in certain conditions, such as some sexually transmitted infections like gonorrhea, which can cause both joint pain and urinary symptoms.


What are the potential causes of blood in urine?

Blood in urine, or hematuria, can be caused by a variety of conditions including urinary tract infections, kidney stones, trauma, or more serious conditions like kidney disease or cancer. It's important to consult a healthcare provider for an accurate diagnosis.


How can systemic lupus erythematosus (SLE) be diagnosed?

Systemic lupus erythematosus (SLE) is diagnosed through a combination of clinical evaluation and laboratory tests. These may include blood tests to check for specific antibodies, urine tests, and sometimes imaging studies. A rheumatologist often manages the diagnosis and treatment of SLE.

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