A Woman With Multiple New Sexual Partners Has Fatigue, Pain

Allan Dong, MD; Jing Wang, MD


October 27, 2022

Physical Examination and Workup

Upon examination, the patient is alert and oriented and in no acute distress. She has a temperature of 99.1 °F (37.28 °C), a pulse of 95 beats/min, a blood pressure of 102/60 mm Hg, a respiration rate of 16 breaths/min, and an oxygen saturation of 99% on room air. No scleral icterus, jaundice, or lymphadenopathy is noted. Heart and lungs are clear to auscultation. Her abdomen is soft, nontender to palpation, and without hepatosplenomegaly. She has trace pedal edema, but the remainder of her examination is largely unremarkable.

Routine laboratory studies and a prenatal panel reveal these values:

  • Blood type: A+

  • Antibody screen: Negative

  • White blood cell count: 6.8 × 109/L (reference range, 4.5-11.0 × 109/L)

  • Hemoglobin level: 12.1 g/dL (reference range, 11.6-15 g/dL)

  • Hematocrit: 36.7% (reference range, 35.5%-44.9%)

  • Platelet count: 230 × 109/L (reference range, 150-400 × 109/L)

  • Creatinine level: 0.41 mg/dL (reference range, 0.5-1.1 mg/dL)

  • Glucose level (random): 92 mg/dL (fasting reference range, 70-99 mg/dL)

  • Alanine aminotransferase level: 221 U/L (reference range, 7-56 U/L)

  • Aspartate aminotransferase level: 60 U/L (reference range, 8-33 U/L)

  • Rubella immunoglobulin G level: 84.7 IU/mL (reference range, > 9 IU/mL)

  • Urine culture: 20-50,000 colony-forming units/mL, with no predominating organism

Additional test results are pending.


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