Concerns of Persistent Lower Back Pain and Possible Kidney Infection
A 39-year-old female, standing at 5'8" and weighing 192 pounds, does not engage in alcohol, smoking, or drug use. She is prescribed a daily dosage of 40mg Vyvanse for ADHD. Recently, she experienced discomfort in her pelvic area and pain in the right flank, accompanied by a frequent urge to urinate in small amounts. Additionally, she noticed sensitivity around the outer genital area. Despite limited urination in the mornings, her condition improved somewhat this week with adequate hydration. Due to the unavailability of her family doctor, she sought treatment at the emergency room. The medical staff conducted a urine culture and urinalysis. Unfortunately, the urinalysis yielded inconclusive results because of contamination from menstrual blood, while the culture showed signs of contamination and colonization. The doctors speculated that it might be a kidney infection and prescribed cefixime for a course of seven days. Currently, the patient still experiences discomfort in the lower back and flank areas, although the pelvic pain has subsided. She is now on the second to last day of her antibiotic treatment and reported slight nausea before starting the antibiotics, which has mostly resolved. She has not had any new sexual partners and is with her partner continuously, ruling out infidelity. Occasionally, she uses a home hot tub treated with chlorine, with regular monitoring of chemical levels to ensure safety. As she is on day eight of her menstrual cycle, and taking rivaroxaban (10mg daily) for a recent thrombophlebitis clot that developed two months ago, she remains cautious, understanding that menstruation might again contaminate any urinalysis. Just recently, she overcame a dental abscess with antibiotic treatment a month earlier and had a suspected case of strep throat that has since resolved without medication, as deemed unnecessary by professionals. Despite the absence of any significant routine changes, she has lost 10 pounds by cutting out sugar and refined carbohydrates in an effort to avoid further dental issues that arose despite good oral hygiene practices. The patient is contemplating whether to return to the ER because the discomfort in her lower back and flank persists. She has been managing her symptoms through stretching, resting, staying hydrated, and using topical pain relief for what she suspects might be muscle discomfort, yet this pain feels more internal. Both she and the emergency room staff seemed uncertain about the accuracy of the kidney infection diagnosis, particularly in a medical facility that often feels overwhelmed due to understaffing, making her hesitant about seeking further evaluation. Although the pain is not severe, it remains a persistent mild to moderate discomfort.
Answers (1)
9/9/2025, 8:10:41 PM
OpenHealth AI
Main Points: Persistent lower back and flank pain after treatment for a suspected kidney infection can be concerning. While your symptoms have improved somewhat, continuing discomfort should be monitored closely.
Explanation: Based on your description, it seems you may have had a suspected kidney infection that is being treated with antibiotics. However, the ongoing discomfort could be due to lingering inflammation or another cause, such as muscle strain, especially if you’ve been stretching and resting but still feel discomfort. The issue is compounded by the contamination in your urine tests, making it difficult to confirm or rule out an infection.
Your history of medications, including rivaroxaban, and your menstrual cycle can impact urinalysis accuracy. Your recent weight loss and dietary changes are positive, but it's essential to ensure you're not overlooking a potential underlying issue that may require attention.
Next Steps:
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Monitor Symptoms: Keep a close eye on your discomfort. Note if the pain increases in intensity, changes in character, or is accompanied by new symptoms like fever, chills, or worsening urination issues.
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Hydration & Rest: Continue to stay hydrated and incorporate rest as needed. This can help with overall recovery from any inflammation or irritation.
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Apply Heat & Gentle Movement: Apply heat to the affected area to help with muscle relaxation. Gentle stretching or yoga may provide relief but avoid any activities that exacerbate the pain.
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Consider Follow-Up: Given your ongoing discomfort and uncertainty about the initial diagnosis, it would be prudent to seek further evaluation if symptoms do not resolve. If pain persists or worsens, or if new symptoms arise, returning to the ER or contacting another healthcare provider would be appropriate.
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Maintain a Symptom Diary: Document your pain levels, urination patterns, and any other symptoms daily. This information can be very helpful for any healthcare provider when assessing your condition.
Your health and comfort are priorities, so stay proactive about any concerning changes.
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