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Updated 03 July 2015

What's your diagnosis? – Case 17: burning urine

Mrs T is a 55 year old secretary with lower abdominal pain. She also sometimes has burning urine. Read the full case and see if you can solve this week’s puzzle.

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Mrs T (55), a secretary at a bank, has been suffering from intermittent lower abdominal pain for the past week. For the past two days there's also been a burning sensation when she urinates.

The following is a summary of her doctor’s notes:

History

A one week history of occasional lower abdominal pain (mostly below navel) – cramp-like in nature and not radiating anywhere. Read: Causes of abdominal pain

Also reports burning sensation with urination (dysuria), more frequent urination (frequency) and difficulty holding in urine for a long time (urgency).

She has no vaginal discharge, is not currently sexually active.

No back pain, no reflux and no change in appetite or stool habits.

Currently menstruating, but never experienced severe menstrual pain.

Examination

Generally well. No jaundice, no signs of anaemia, no oedema, no lymph nodes in groin area.

Abdomen: not distended, slightly tender over lower abdomen.  Bowel sounds audible. Not tender over renal angles.

Chest and cardiac examination: normal.

Side-room investigation

Temperature: 37.2 degrees Celsius. Readwhat normal body temperature should be

Blood pressure: 135/80 mmHg, pulse: Read: numbers for normal blood pressure

Pulse rate: 77 beats per minute: Read: average pulse rate for the heart

Urine testing: trace of protein, positive for nitrates, positive for white cells, blood. Read: interpreting urine tests

Based on the above, can you figure out what's wrong with Mrs T?

What's your diagnosis? Join the guesswork on our Facebook page, or comment below.

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays. We'll post the answer with the story on Mondays, or you can get it via the Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? -  Case 1: vomiting and weight loss

What's your diagnosis? -  Case 2: eye pain

What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis? -  Case 4: seeing odd things

What's your diagnosis? - Case 5: mysterious lungs

What's your diagnosis? - Case 6: runner with seizures

What's your diagnosis? - Case 7: swollen knee

What's your diagnosis? - Case 8: bloody semen

What's your diagnosis? - Case 9: confusing neurological signs

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis? - Case 11: bruising with no apparent reason

What's your diagnosis? - Case 12: severe tummy pain

What's your diagnosis? - Case 13: severe sore throat

What's your diagnosis? - Case 14: abdominal pain and swelling

What's your diagnosis? - Case 15: the world is spinning

What's your diagnosis? - Case 16: numbness in forearm

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.

 
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