An 18-year-old female equestrian athlete presented with a chief complaint of dysuria. History Time of onset of dysuria was 2 days prior to presentation. Associated symptoms included mild diffuse abdominal and flank pain, dark colored urine, and increased urinary frequency. She specifically denied chills, fever, nausea, or increased urinary urgency. Prior to the presentation, the patient had not tried any remedies other than increasing fluid intake.
This did not alter her symptoms. She denied any specific exacerbating or relieving factors. Physical Exam Physical examination was within normal limits with the exception of bilaterally enlarged tonsils without exudates. Lab Studies Urinalysis showed moderate bilirubin, positive ictotest, positive ketones, protein 30mg/dl, nitrite negative, leukocytes negative, 0-2 WBC, 0-2 RBC, and few bacteria. CBC showed a WBC 5.5, hemoglobin 14.8,…
