The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 29-year-old woman presents with a 2-week history of fatigue, nausea, and muscle aches. She attributes her symptoms to pregnancy after a home test was positive 1 week ago. This is her first pregnancy. She has regular periods and is confident in the date of her last menstrual period (LMP). Based on her LMP, she is 7 weeks and 1 day pregnant at the time of her presentation.
She reports that her appetite has been somewhat diminished for the past few weeks but does not report any other symptoms, including fever, chills, abdominal pain, chest pain, shortness of breath, headache, constipation, diarrhea, or urinary symptoms. The patient states that this is an unplanned pregnancy. She is married to a long-time male partner; however, she states that she has an open marriage. She reports intercourse with two men and three women within the past year. She has had intercourse with one new male and one new female partner in the past month. She reports that she and her partners use barrier contraceptive methods only rarely.
Her medical history is unremarkable, and she has not had any surgeries in the past. She is not taking any medications. She reports a childhood allergy to penicillin. She received prior treatment for both chlamydia and gonorrhea. She does not report a history of intravenous drug use.
During her annual visit 5 months earlier, she had no complaints. Routine laboratory results were within normal limits, and sexually transmitted infection screening tests for chlamydia, gonorrhea, HIV infection, syphilis, hepatitis B, and hepatitis C were negative at that visit.
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Cite this: A Woman With Multiple New Sexual Partners Has Fatigue, Pain - Medscape - Oct 27, 2022.