A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

 A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

 A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

Case Study Analysis

A 32-year-old woman arrives at the ED with vomiting, nausea, fever, chills, and vaginal discharge for  3 days. LLQ and back discomfort are also reported. Incontinence, peculiar urine, and excessive urination are all denied. She is alone. Sedimentation, WBC, and CRP were all elevated. LLQ pain on abdominal examination. A pelvic exam reveals the chandelier sign, adnexal pain, reddish cervix, and putrid green discharge. diplococci with a negative gram. This paper investigated the aforementioned case and talks about PID and infertility.

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Factors that Affect Fertility (STDs).

PID was diagnosed based on her elevated body temperature and pulse rate among other lab findings. Gonorrhea and chlamydia can migrate to the uterus if left untreated. Inflammation, scarring, and obstruction of the fallopian tubes may be brought on by PID, or pelvic inflammatory disease (Chitneni et al., 2020). Fallopian tubes may become blocked by tubal scarring, which would prevent ova from reaching the uterus. Ectopic pregnancy and infertility are more likely to occur in cases with fallopian tube damage.

Increase in Inflammatory Markers in STD/PID.

STIs cause injury to the vaginal mucosa, which protects against invasive bacteria and viruses. Inflammation of the mucosa comes from STI infections being identified by surface receptors or within the cell (Rizk et al., 2020). Biomarkers of inflammation as CRP and ESR are increased in the example. STIs may result in mucosal responses that, among other things, might lead to discharge, blistering, and warts. Although this response aims to get rid of infections, it often falls short or leads to pathology that compromises the barrier and lets HIV penetrate submucosal target cells.

 

Prostatitis

Prostatitis is a condition that affects the prostate gland and is often accompanied by inflammation. In addition to making peeing awkward or challenging, prostatitis often leads to pain in the groin or genitalia. Although bacterial infections are not the source of all occurrences of prostatitis, certain instances of the illness include (Li et al., 2021). Common bacterial strains often cause acute bacterial prostatitis. The virus may have started in the reproductive or urinary systems before spreading.

Splenectomy and ITP

Immune systems in ITP patients destroy platelets as foreign substances. Eliminating the spleen may allow more platelets to circulate since it eliminates damaged platelets (Tahir et al., 2020). A splenectomy is performed on patients with severe, chronic ITP. Leading US ITP specialists had a splenectomy after trying many different therapies and failing. An indium-labeled platelet spleen scan is carried out by a nuclear medicine department to determine if the spleen is degrading platelets. A splenectomy won’t assist if this test reveals that other areas of the body are where the immune system is mostly destroying platelets.

Anemia

Anemia happens when the body generates less of the typical number of healthy, normal RBCs. MCV may be used to categorize anemia as microcytic (MCV less than 80), normocytic (MCV 80–100), or macrocytic (MCV more than 100) in conjunction with hemoglobin and hematocrit (Tvedten, 2022). Additional types of anemia include aplastic, hemolytic, and sickle cell anemia depending on the underlying cause.

Conclusion

PID is a typical infection that affects sexually active women. STIs like gonorrhea and chlamydia are often to blame. Untreated PID may prevent a person from being able to have children. Therefore, if the issue is serious and continues recurring, surgery may be required.

References

Chitneni, P., Bwana, M. B., Owembabazi, M., O’Neil, K., Kalyebara, P. K., Muyindike, W., Musinguzi, N., Bangsberg, D. R., Marrazzo, J. M., Haberer, J. E., Kaida, A., & Matthews, L. T. (2020). Sexually Transmitted Infection Prevalence Among Women at Risk for HIV Exposure Initiating Safer Conception Care in Rural, Southwestern Uganda. Sexually Transmitted Diseases, 47(8), e24–e28. https://doi.org/10.1097/olq.0000000000001197

Li, C., Xu, L., Lin, X., Li, Q., Ye, P., Wu, L., Wang, M., Li, L., Li, L., Zhang, Y., Li, H., & Qin, G. (2021). Effectiveness and safety of acupuncture combined with traditional Chinese medicine in the treatment of chronic prostatitis. Medicine, 100(49), e28163. https://doi.org/10.1097/md.0000000000028163

Rizk, B., Borahay, M. A., & Abdel Maguid Ramzy. (2020). Clinical Diagnosis and Management of Gynecologic Emergencies. CRC Press.

Tahir, F., Ahmed, J., & Malik, F. (2020). Post-splenectomy Sepsis: A Review of the Literature. Cureus, 12(2). https://doi.org/10.7759/cureus.6898

‌Tvedten, H. (2022). Classification and Laboratory Evaluation of Anemia. Schalm’s Veterinary Hematology, 198–208. https://doi.org/10.1002/9781119500537.ch25

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In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (Below is a list of questions that will need to be addressed within your paper. Not all will apply to scenario. You will need address all of the questions even if they are not directly related to the scenario):

• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Case Scenario:

A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, ­ Neuts & Lymphs, sed rate 46 mm/hr, C-reactive protein 67 mg/L CMP wnl

Vital signs T 103.2 F Pulse 120 Resp 22 and PaO2

99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. Pelvic exam demonstrates copious foul-smelling green drainage with reddened cervix and + bilateral adenexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.