Allergies to Penicillin (rash, itching, nausea, and vomiting)

Allergies to Penicillin (rash, itching, nausea, and vomiting) Chief Compliant: UTI Onset: Her UTI symptoms began three days ago Location: Pain in the urethra 7/10 Duration: Reports increased urinary frequency Characteristics: She has experienced pain during urination, a burning sensation, and increased urgency to urinate. She is also experiencing some cramping in her lower abdominal region. Aggravating Factors: Urination makes the pain worse Relieving Factors: Drinks less water so she doesn’t have burning Treatment: Cranberry pills, 3 days ago when symptoms started Patient is a 21-year-old biracial woman presenting with an uncomplicated UTI. The onset took place 3 days ago, located in the urethra with 7/10 for pain, and urinates frequently. Pt reports pain with urination, a burning sensation and increased urgency, and cramping in lower abdominal region. Aggravating factors include urination, reliving factors include drinking less water to avoid burning, and self-treated with cranberry pills. 3 Differential Diagnosis 1) Cystitis - The clinical diagnosis of cystitis is made in a patient who has classic signs and symptoms (ie, dysuria, urinary frequency, urgency, and/or suprapubic pain). For women who have atypical urinary symptoms, the diagnosis is supported by the presence of pyuria and bacteriuria on urinalysis and/or culture. 2) Urethritis - Evaluation for urethritis is warranted in sexually active women with dysuria, particularly those with pyuria on urinalysis but no bacteriuria. Causes of urethritis in women include chlamydia, gonorrhea, trichomoniasis, Candida species, herpes simplex virus, and noninfectious irritants, such as a contraceptive gel. 3) Painful bladder syndrome – This is a diagnosis of exclusion in women who have ongoing discomfort related to the bladder with symptoms of dysuria, frequency, and/or urgency but no evidence of infection or other identifiable cause. Review of Systems Constitutional - No fever Gastrointestinal - Reports lower ABD cramping Menstrual Cycle - LMP 2 weeks ago - Last 4 days with light bleeding for 3 days afterwards - MP are regular & predictable due to oral contraceptive Genitourinary (GU) - Urgency - Dysuria - Burning - Polyuria Past Medical History - No existing relevant health conditions, seasonal environmental allergy Medications - Loratadine 10mg Antihistamine (Allergic Rhinitis) - Ethinyl Estradiol and Norgestimate combination (Contraceptive) - Cranberry pills Family History - Father is in go