Case Study Analysis Assignment

Due by Day 7 Week 10

Scenario 1: 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 adnexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram negative diplococci.

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Case Study Analysis Assignment

Introduction

Sexually transmitted diseases can harm the fertility of women to get children. In the case that an STD is not treated even in the case that the disease is asymptomatic it may lead to issues of Pelvic Inflammatory Disease as posited by Tsevat et al. (2017). This leads to issues of scarring being found in the fallopian tubes hence causing difficulties in conception since it becomes challenging for the sperm to reach the egg. The condition may lead to issues of having an ectopic pregnancy and in this paper an analysis of the factors that are involved in the fertility issues in women with STDs.

Factors that affect fertility (STDs)

One of the factors the increase the risk of infertility is the issue of STD that could manifest through symptoms including vaginal discharge and issues of having foul-smelling urine. The issue of STD may lead to risks of PID where a patient may have issues of chills, fever, and abdominal health challenges that show that a patient has issues of the inflamed pelvic area. In the case of the 32-year-old female, it is evident that she may be suffering from STDs such as gonorrhea or chlamydia. The condition leads to infertility by causing an inflammation hence leading to the prevention of the right movement of the sperm and the egg for fertilization to occur.

Why inflammatory markers rise in STD/PID

There is a rise of a rise in inflammatory markers like C-reactive protein and white blood cells. This occurs as a result of the rise in bacterial infection. The patient has a high level of WBC and C-reactive cells showing that she is having a bacterial infection. Ingerslev et al. (2017) allude that in the case of a bacterial infection, the body of an individual will produce a high level of WBC that helps in fighting the bacteria hence leading to the high levels of WBC. Similarly, the C-reactive protein will rise simultaneously. The adnexal tenderness in the case of the patient in the case study is an indication of the issue of inflammation….

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