Differential Diagnosis for 15 yo F with LLQ Pain, Nausea, Vomiting, and Dysuria
- Single Most Likely Diagnosis
- Pelvic Inflammatory Disease (PID): The patient's symptoms of lower left quadrant (LLQ) pain, nausea, vomiting, and dysuria, combined with the fact that she is on birth control, suggest a possible infection of the reproductive organs. Birth control can sometimes mask symptoms of PID, making it a likely consideration.
- Other Likely Diagnoses
- Urinary Tract Infection (UTI): Dysuria is a common symptom of UTIs, and the presence of nausea and vomiting could indicate a more severe infection such as pyelonephritis.
- Ovarian Cyst: The LLQ pain could be related to an ovarian cyst, which can cause significant pain and nausea. The use of birth control can affect ovarian cyst formation.
- Appendicitis: Although appendicitis typically presents with right lower quadrant pain, it can sometimes present atypically, especially in females, and should be considered in the differential diagnosis of abdominal pain.
- Do Not Miss Diagnoses
- Ectopic Pregnancy: Despite being on birth control, the possibility of an ectopic pregnancy cannot be ruled out without a pregnancy test. Ectopic pregnancy is a life-threatening condition that requires immediate attention.
- Ruptured Ovarian Cyst: A ruptured ovarian cyst can lead to severe internal bleeding and is a medical emergency.
- Septic Abortion: If the patient is pregnant and has undergone an abortion, there is a risk of septic abortion, which is life-threatening.
- Rare Diagnoses
- Endometriosis: While endometriosis can cause chronic pelvic pain, it is less likely to cause acute symptoms like nausea, vomiting, and dysuria.
- Diverticulitis: This condition is rare in young females but can cause LLQ pain and should be considered if other diagnoses are ruled out.
- Tubo-ovarian Abscess: A complication of PID, this is a rare but serious condition that requires prompt medical attention.