[33F] Experiencing foul-smelling urine and other symptoms
Patient Description
A 33-year-old female reports foul-smelling urine reminiscent of sewer water, an issue persisting for several years with temporary relief from antibiotics. The urine is described as cloudy and yellow. Additionally, the patient experiences intermittent swelling in the feet, ankles, and lower legs, noticeable after removing socks and shoes, and unassociated with specific activities. Swelling in the hands was also noted once. The patient suffers from itchy skin, leading to hives that are raised, red, and spread upon scratching, persisting for about a year. The patient has livedo reticularis, which has worsened and is exacerbated by cold. There is a history of chronic gastroenteritis, hypertension stage 2, and tachycardia, managed with metoprolol (20 mg daily) and omeprazole for stomach pain. The patient experiences occasional nausea after large meals and severe stomach pain in the morning or on an empty stomach, ongoing for about a year. Recent developments include red unraised dots on the chest, attributed to high blood pressure and blood vessel damage, similar to those experienced during a past episode of preeclampsia. Varicose veins are present on the back of the legs.
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Arora's Assessment
What might be happening
Based on the information you've provided, there are several possible explanations for your symptoms:
- Urinary Tract Infection (UTI): The foul smell of your urine, along with its cloudy appearance and presence of nitrates, could indicate a UTI. UTIs are typically caused by bacteria and can be treated with antibiotics.
- Chronic Venous Insufficiency: The swelling in your feet and ankles, along with the presence of varicose veins, could be due to chronic venous insufficiency. This condition occurs when your leg veins don't allow blood to flow back up to your heart.
- Allergic Reaction or Dermatological Condition: The itchy skin and hives that spread when you scratch could be due to an allergic reaction or a skin condition. It's also possible that the livedo reticularis is related to this.
- Gastroenteritis: Your chronic gastroenteritis could explain the nausea and stomach pain you experience, especially after eating or when your stomach is empty.
- Potential Blood Disorders: The presence of red unraised dots on your chest, along with your blood and urine test results, could suggest a blood disorder. However, this would need to be confirmed with further testing.
What you can do
- Consult with a healthcare provider: Given the range and severity of your symptoms, it's important to seek medical attention. They can provide a formal diagnosis and appropriate treatment.
- Monitor your symptoms: Keep track of your symptoms and any potential triggers. This information can be helpful for your healthcare provider.
- Stay hydrated: Drinking plenty of water can help with UTIs and also improve your overall health.
- Elevate your legs: If possible, try to elevate your legs when you're sitting or lying down. This can help reduce swelling in your feet and ankles.
What you should look out for
Seek immediate medical attention if you experience any of the following:
- Severe abdominal pain
- Blood in your urine
- A high fever (temperature over 100.4°F)
- Rapid, unexplained weight loss
- Difficulty breathing
Please remember that while I strive to provide accurate and helpful health information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.
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10 mo ago