Differential Diagnosis for Yellow Discharge Vagina and Abdominal Pain with High CRP

Single Most Likely Diagnosis

• Pelvic Inflammatory Disease (PID): This condition is characterized by inflammation of the female reproductive organs, often caused by bacterial infections such as gonorrhea or chlamydia. The symptoms of yellow discharge, abdominal pain, and a very high CRP (C-reactive protein) level are consistent with PID, which typically presents with lower abdominal pain, abnormal vaginal discharge, and elevated inflammatory markers.

Other Likely Diagnoses

• Endometritis: An inflammation of the endometrium, often due to infection, which can cause abdominal pain, abnormal vaginal discharge, and elevated CRP levels.
• Salpingitis: Inflammation of the fallopian tubes, usually due to infection, which can present with abdominal pain, vaginal discharge, and signs of inflammation like high CRP.
• Vaginitis: Inflammation of the vagina, which can be caused by infections (bacterial, yeast, or trichomonas) and may present with abnormal discharge, though the abdominal pain and high CRP might suggest a more complex or severe infection.

Do Not Miss Diagnoses

• Ectopic Pregnancy: Although less likely if a pregnancy test is negative, an ectopic pregnancy can present with abdominal pain and vaginal bleeding or discharge. It's a life-threatening condition that requires immediate attention.
• Appendicitis: While the primary symptom is abdominal pain, appendicitis can sometimes present with vague or atypical symptoms, including elevated CRP. It's crucial to consider, especially if the pain is localized to the right lower quadrant.
• Ovarian Torsion: A gynecological emergency that can cause severe abdominal pain and might be associated with elevated inflammatory markers. It's less common but critical to diagnose promptly.

Rare Diagnoses

• Tuberculosis (TB) of the Genital Tract: A rare condition in many parts of the world but can cause chronic abdominal pain, abnormal vaginal discharge, and elevated CRP levels.
• Actinomycosis: A rare bacterial infection that can cause chronic inflammation and abscesses in the pelvic area, leading to abdominal pain, discharge, and elevated inflammatory markers.
• Malignancies: Such as ovarian or cervical cancer, which can present with a variety of symptoms including abdominal pain and abnormal vaginal discharge, though they would be less likely to cause a sudden spike in CRP unless there's an associated infection or acute event like tumor rupture.