Abdominal pain in a 20 year old female, what could this case be?

20 year old female presents to the ER with abdominal pain. Afebrile and normal vitals. Pregnancy test negative. Labs normal. Ultrasound normal, no stones. CT (resident read) shows nonspecific inflammatory findings. Patient is sent home and her chlamydia test later returns positive. Attending CT read finds significant inflammatory findings in the mesentery and omentum, and she is told to return to the ER. Negative GU physical exam. But she is treated for PID with doxy and ceftriaxone. Later... Abdominal pain in a 20 year old female, what could this case be?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Medical Students - MD Source Type: forums

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CONCLUSIONS: Based on the results of this systematic review, the POC test based on antigen detection has suboptimal sensitivity but good specificity. Performance of this test translates, on average, to a 52% chance of mistakenly indicating absence of infection and a 2% chance of mistakenly pointing to the presence of this condition. Because of its deleterious consequences for reproductive health, and considering the current availability of safe and effective interventions to treat C trachomatis infection, the POC screening strategy should not be based on a rapid diagnostic test for antigen detection. Research in this topic...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract Pelvic inflammatory disease (PID) is an infection of the upper genital tract occurring predominantly in sexually active young women. Chlamydia trachomatis and Neisseria gonorrhoeae are common causes; however, other cervical, enteric, bacterial vaginosis-associated, and respiratory pathogens, including Mycobacterium tuberculosis, may be involved. PID can be acute, chronic, or subclinical and is often underdiagnosed. Untreated PID can lead to chronic pelvic pain, infertility, ectopic pregnancy, and intra-abdominal infections. The diagnosis is made primarily on clinical suspicion, and empiric treatment is re...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Semin Reprod Med 2018; 36: 340-350 DOI: 10.1055/s-0039-1678752 Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the United States. Within the U.S. military, the age- and race-adjusted chlamydia infection rates among female service members are consistently higher than civilian rates, with a 20% annual acquisition rate among young active-duty women. The sequelae of chlamydia disproportionately impact women in terms of severity and cost. Untreated chlamydia progresses to pelvic inflammatory disease in 40% of cases, and is a leading cause of fallopian tube damage and pelvic adhesive disea...
Source: Seminars in Reproductive Medicine - Category: Reproduction Medicine Authors: Tags: Review Article Source Type: research
ConclusionsUrethral diverticula should be excluded whenever a patient exhibits unresolved, nonspecific urinary problems. This is an underdiagnosed problem. Pregnancy presents additional challenges, but does not preclude medical or surgical treatment in the patient with significant symptoms.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
This study showed a high prevalence (18%) of CT infection among pregnant women in Coari / Amazonas. Urine sampales were as good as cervical-vaginal ones for the screening of CT infection during the prenatal period. PMID: 30785560 [PubMed - in process]
Source: Revista do Instituto de Medicina Tropical de Sao Paulo - Category: Tropical Medicine Authors: Tags: Rev Inst Med Trop Sao Paulo Source Type: research
CONCLUSIONS: In men, regimens with azithromycin are probably less effective than doxycycline for microbiological failure, however, there might be little or no difference for clinical failure. For women, we are uncertain whether azithromycin compared to doxycycline increases the risk of microbiological failure. Azithromycin probably slightly reduces adverse events compared to doxycycline in men and women together but may have little difference in men alone. We are uncertain whether doxycycline compared to ofloxacin reduces microbiological failure in men or women alone, or men and women together, nor if it reduces clinical f...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Sexually transmitted disease (STD) rates in the U.S. are at a record high for the fourth year in a row, according to new data from the Centers for Disease Control and Prevention (CDC). All told, nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the U.S. in 2017. That’s 200,000 more cases than were diagnosed in 2016, a year that also had a record-high number of cases, according to the CDC. “We are now very concerned about this steep and sustained increase that we’re seeing,” says Dr. Gail Bolan, the director of the CDC’s Division of STD Prevention. “We’...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized healthytime onetime Sex/Relationships Source Type: news
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 24-year-old woman is evaluated for severe cramps associated with her menstrual periods. The cramps have worsened over the past year, and the discomfort is severe enough that she has periodically missed work. She reports no abnormal vaginal discharge. Menses are unchanged from her baseline pattern. She has tried ibuprofen and naproxen for pain relief, but these medications cause stomach upset. The patient is sexually active with several male partners. She has no history of sexually transmitted infection...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions OB/GYN Source Type: blogs
DiscussionThis trial is expected to largely contribute to the development of recommendations for Ct screening in young women in France to prevent PID and related complications. It is part of a comprehensive approach to gathering data to facilitate decision-making regarding optimal strategies for Ct infection control. The control group of this randomised trial, following current recommendations, will allow better documentation of the natural history of Ct infection, a prerequisite to evaluating the impact of Ct screening. Characterisation of host immunogenetics will also allow identification of women at risk for complicatio...
Source: Trials - Category: Research Source Type: clinical trials
Discussion In the US during 2011, ~60,000 youth were incarcerated at some time in a correctional facility. Boys are detained more than girls (86% vs 14% respectively in the US, 95% male in the United Kingdom in 2014) but girls have more health issues. There are racial and ethnic differences with 38-40% of detainees being black, 23% being Hispanic/Latino and 32% being white, and 5% other. For detained youth, 5% are for violent crimes, 22% for non-violent property crimes and the majority of the rest are for non-violent offices such as substance use. The average length of detainment is 3-4 months and unfortunately the rates o...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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