Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What is normal vaginal discharge?
What are the different types of vaginal discharge?
When should I be concerned about vaginal discharge?
How can I treat abnormal vaginal discharge?
Can changes in vaginal discharge indicate pregnancy?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
So you want to focus on the green discharge today, is that correct?
Patient
Yes.
Cody, the AI Doctor
Great to meet you. My goal is to provide you with an accurate assessment and plan. Let's talk about your concerns regarding the green discharge. Have you experienced any recent changes in your diet or started taking any new supplements or medications that could potentially cause changes in your discharge color?
Patient
Yes, I'm on a calorie deficit and I'm taking a whitening product.
Cody, the AI Doctor
Changes in diet, such as being on a calorie deficit, can sometimes affect vaginal discharge color. When did you first start experiencing green discharge? For example, was it 2 weeks ago or 2 days ago?
Patient
Almost one year.
Cody, the AI Doctor
Green discharge lasting for almost a year may indicate an underlying infection or other medical condition that needs to be evaluated by a healthcare provider. Have you been diagnosed with any medical conditions? For example, diabetes, thyroid disorders, or autoimmune diseases?
Patient
No, I have none of those.
Cody, the AI Doctor
The green discharge lasting for an extended period can be a sign of an underlying infection or medical condition. In what year were you born?
Patient
2004.
Cody, the AI Doctor
The year of birth can help me understand your age and provide better care. Is your green discharge getting worse, getting better, staying the same, or does it vary day to day?
Patient
Vary day to day.
Cody, the AI Doctor
Green discharge can be a sign of infection or other underlying issues. How did your green discharge start? Did it start suddenly or gradually?
Patient
Yes, it started like small, little chunks at first and then turned watery.
Cody, the AI Doctor
Green discharge can be a sign of infection or other underlying issues. On a scale of 1 to 10, how severe would you rate the green discharge you are experiencing, where 1 is no problem and 10 is very severe?
Patient
I would say 8 out of 10 when it is most severe.
Cody, the AI Doctor
Assessing the severity of your symptoms can help determine the urgency of the situation and guide the appropriate next steps in your care. Do you have any fever or chills? Do you have a belly pain? Do you have pain with urination? Do you have any vaginal bleeding? Do you have diarrhea?
Patient
I only have pain when I pee. No bleeding, no stomach pain, nothing else.
Cody, the AI Doctor
Any chance you are pregnant currently?
Patient
No way. I have an IUD and I just tested negative twice with a home kit.
Cody's AI Summary
- You are a 24 year-old woman with green vaginal discharge for almost a year.
- The green discharge varies day to day in consistency.
- You rated the severity of your green discharge as an 8 out of 10.
- You mentioned having pain during urination as a symptom.
- You have no other medical problems.
- You are unlikely to be pregnant.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Trichomoniasis( 60 % probability)
A sexually transmitted infection that can cause greenish-yellow discharge and discomfort during urination.
2. Bacterial Vaginosis(25 % probability)
A common vaginal infection that can cause green or gray discharge with a fishy odor.
3. Gonorrhea(15 % probability)
A sexually transmitted infection that can cause greenish-yellow discharge and pain during urination.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
The patient has a prolonged history of green vaginal discharge and pain during urination. The differential diagnosis given by CodyMD, our AI Doctor, points primarily towards infectious etiologies, which are reasonable given the presentation.
1. Trichomoniasis(70% probability)
This sexually transmitted infection often presents with greenish-yellow discharge and genital discomfort, including pain during urination. Trichomoniasis is the most likely diagnosis due to the combination of the patient's prolonged symptoms and the specific color and consistency of the discharge. Trichomoniasis frequently goes untreated for long periods, because it is often misdiagnosed or asymptomatic in previous examinations.
2. Bacterial Vaginosis(20% probability)
Bacterial Vaginosis typically produces a gray or greenish discharge with a characteristic fishy odor. Pain during urination can sometimes occur but is less common. While Bacterial Vaginosis is a common vaginal infection and should be considered, the symptom of pain during urination combined with green discharge is less characteristic of this condition. The variable nature of the discharge severity also fits less neatly with what we usually see with Bacterial Vaginosis.
3. Gonorrhea(10% probability)
This STD can also cause greenish-yellow discharge and dysuria. A longer duration of symptoms is less typical but still possible in untreated or recurrent cases. Gonorrhea might be a less likely diagnosis here due to the longer duration without developing more severe symptoms or complications typically associated with untreated Gonorrhea, like pelvic inflammatory disease. Additional considerations include non-infectious causes such as vaginitis due to chemical irritants or a rare presentation of a yeast infection. However, the chronic nature and the described symptoms make these less likely compared to infectious etiologies.
Next Steps for Evaluation
General Examination: Conduct a thorough history including asking about sexual partners and perform a pelvic examination to check for other signs of inflammation or anatomical anomalies.
Diagnostic Testing: The patient should undergo diagnostic swabs and cultures for sexually transmitted infections, including Trichomoniasis, Gonorrhea, and a test for Bacterial Vaginosis, and swabs for yeast infection.
Screen for other STIs: Given the sexual transmission possibility, a full STI panel, including Chlamydia and Gonorrhea should be obtained.
Potential Treatment Modalities
Medication: If an infection is confirmed, the respective antibiotics or antimicrobial treatments should be initiated. For instance, Metronidazole is commonly used to treat Trichomoniasis and Bacterial Vaginosis.
Symptom Management: Pain relief for dysuria might include non-steroidal anti-inflammatory drugs (NSAIDs).
Life-style management: Remain very well hydrated.
Resource Center
Testimonials
Honestly, this is the best doctor I've ever come across. … and I'm very grateful for the experience.
TrustPilot Review
Attentive and asked questions. I really felt like all my symptoms were taken into account and evaluated without being dismissed.
TrustPilot Review
After trying out multiple similar websites, I am so happy I found CodyMD. The user friendly score is 100%! I was amazed at how fast my questions were answered with my info taken into consideration, not one generic answer. This site is truly brilliant and will benefit soo many people as far as time and money.
TrustPilot Review
