A Young Woman with Abdominal Pain (1)
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.