Differential Diagnosis
- Single most likely diagnosis
- Schistosomiasis: The patient's recent history of swimming in a dam in Austria, a region where schistosomiasis is rare but possible, especially in immigrants or travelers from endemic areas, combined with the symptoms appearing 2 days after the end of their menstrual period, suggests a possible infection. Schistosomiasis can cause symptoms like abdominal pain, diarrhea, and sometimes genital symptoms, although the latter are not mentioned here.
- Other Likely diagnoses
- Urinary Tract Infection (UTI): Given the patient's symptoms and the absence of genital findings, a UTI is a plausible diagnosis, especially if the patient has experienced similar infections in the past or has a history of urinary tract issues.
- Pelvic Inflammatory Disease (PID): Although the patient is married with a single partner and no genital findings are reported, PID cannot be ruled out entirely, especially if the patient has had recent sexual activity or if there's an undiagnosed sexually transmitted infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic Pregnancy: Despite the patient being married with a single partner and having no reported genital findings, ectopic pregnancy is a critical diagnosis to consider, especially if there's any chance of pregnancy, due to its potentially life-threatening nature.
- Ovarian Torsion: This condition, although rare, is an emergency that requires immediate attention. The patient's symptoms of abdominal pain could potentially be related to ovarian torsion, especially if there's a history of ovarian cysts or other predisposing factors.
- Rare diagnoses
- Lymphogranuloma Venereum (LGV): This sexually transmitted infection can cause a range of symptoms, including abdominal pain and systemic symptoms, but it is relatively rare and typically associated with specific sexual practices or exposure history.
- Genital Tuberculosis: Although rare in many parts of the world, genital tuberculosis can cause a variety of symptoms, including abdominal pain, and should be considered in patients from or who have traveled to endemic areas, especially if they have a history of tuberculosis exposure or infection.