Abstract
Sarah, an 18-year-old woman, presents to her General Practitioner with a 1-week history of intermittent cramping lower abdominal pain and increased vaginal discharge. She has felt feverish. Her bowel movements have been normal and she has had no urinary symptoms. For the past 4 months she has been in a regular relationship with a young man. They last had sex 3 days previously during which Sarah experienced lower abdominal pain. Her menstrual cycle has always been regular, the last period having been 3 weeks previously and normal. She has, however, noticed intermittent slight vaginal bleeding since then. Condoms are used for contraception, but occasionally, most recently 3 weeks ago, intercourse has been unprotected.
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Notes
- 1.
Serum chorionic gonadotrophin (hCG) assays on serum and urine can detect pregnancy within 7–10 days and 14–18 days post-ovulation, respectively. It is therefore possible to diagnose pregnancy before the first missed period.
- 2.
Severe disease is associated with fever (temperature >38°C), malaise, anorexia, and vomiting. There is tenderness and guarding in the lower abdomen. The total white cell count in the peripheral blood is elevated and both the erythrocyte sedimentation rate (ESR) and the C-reactive protein concentration are raised, particularly in chlamydial PID.
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© 2009 Springer-Verlag London
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McMillan, A. (2009). A Young Woman with Abdominal Pain (1). In: Sexually Transmissible Infections in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84882-557-4_14
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DOI: https://doi.org/10.1007/978-1-84882-557-4_14
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