[42F] With itchy, painful bump and vaginal discharge

Patient Description

A 42-year-old female presents with a medium to large white patch on the inside of her butt cheek, which has been present for a couple of months. The bump is itchy, painful, and makes it uncomfortable to sit. It is soft and stays in one place. Initially, it was getting larger, but now it is getting smaller, although the pain has increased as it shrinks. The area around the bump is wet, suggesting it might be draining slowly. Additionally, the patient has experienced night sweats but no fever or chills. There is a little pus or unusual discharge coming from the bump. The patient also reports a foul smell coming from her vagina, especially when wearing underwear for extended periods, which smells like ammonia. She has a discharge that is sometimes gray and sometimes white. She experiences occasional pain in her stomach, particularly on the left side or in the middle, along with frequent nausea and extreme fatigue. The nausea is strong, lasts for varying durations, and does not lead to vomiting. Medical history includes asthma diagnosed in childhood, high blood pressure, and fluid retention for about 15 years. The patient is allergic to aspirin and the substances used in epidurals. Currently, she is not taking any medications, although she should be on high blood pressure medicine.

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Arora's Assessment

What might be happening

Based on the symptoms and medical history you've provided, here are some possible explanations:

  • Abscess or Boil: The painful, itchy bump on your butt cheek that is draining could be an abscess or boil. These are often caused by bacterial infections and can become quite painful as they drain.

    • Treatment typically involves keeping the area clean and applying warm compresses. In some cases, a doctor may need to drain the abscess or prescribe antibiotics.

  • Bacterial Vaginosis (BV): The foul-smelling vaginal discharge that smells like ammonia and varies in color could be due to bacterial vaginosis. BV is a common bacterial infection that can cause a fishy odor and discharge.

    • Treatment usually involves antibiotics prescribed by a doctor.

  • Pelvic Inflammatory Disease (PID): Given your history of gonorrhea, the abdominal pain, nausea, and fatigue could be signs of PID, a serious infection of the female reproductive organs that can occur if sexually transmitted infections are not fully treated.

    • Treatment involves antibiotics, and it's crucial to seek medical attention promptly to prevent complications.

  • Chronic Fatigue Syndrome (CFS): The extreme fatigue and the ability to fall asleep at any moment could be indicative of chronic fatigue syndrome, especially if it has been ongoing for several months.

    • Management includes lifestyle changes, medications, and sometimes therapy to help manage symptoms.

What you can do

  1. Consult a Doctor: Given the range of symptoms and their severity, it's important to consult a healthcare provider for a thorough evaluation and appropriate treatment.
  2. Maintain Hygiene: Keep the area around the bump clean and dry. Use warm compresses to help with drainage and pain.
  3. Monitor Symptoms: Keep a symptom diary to track any changes or patterns in your symptoms, which can be helpful for your healthcare provider.
  4. Stay Hydrated and Eat Well: Ensure you are drinking plenty of water and maintaining a balanced diet to support your overall health.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe Pain: If the pain in your abdomen or the bump becomes severe.
  • High Fever: If you develop a fever (temperature over 100.4°F).
  • Increased Discharge or Odor: If the vaginal discharge becomes more pronounced or the odor worsens.
  • Spreading Redness or Swelling: If the area around the bump becomes more red, swollen, or painful, indicating a possible spreading infection.

Remember, while this information can help guide you, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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5 mo ago

People Also Ask

What could cause a painful, itchy bump on the skin that drains slowly?

A painful, itchy bump on the skin that drains slowly could be an abscess or boil, often caused by a bacterial infection. Treatment typically involves keeping the area clean, applying warm compresses, and sometimes requires medical intervention such as drainage or antibiotics.

What are the symptoms and treatment options for bacterial vaginosis?

Bacterial vaginosis (BV) is characterized by a foul-smelling vaginal discharge that can be gray or white and may smell like ammonia. It is caused by an imbalance of bacteria in the vagina. Treatment usually involves antibiotics prescribed by a doctor.

How can pelvic inflammatory disease affect overall health, and what are its symptoms?

Pelvic inflammatory disease (PID) can cause abdominal pain, nausea, and fatigue. It is a serious infection of the female reproductive organs, often resulting from untreated sexually transmitted infections. Treatment involves antibiotics, and prompt medical attention is crucial to prevent complications.

What are the common signs of chronic fatigue syndrome, and how is it managed?

Chronic fatigue syndrome (CFS) is marked by extreme fatigue that doesn't improve with rest and can last for several months. Management includes lifestyle changes, medications, and sometimes therapy to help manage symptoms. It is important to consult a healthcare provider for a proper diagnosis and treatment plan.

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