A 12 year old girl presents to the clinic with painful urination that has persisted for weeks. She reports she has painful urination multiple times. She does not have any reported abdominal pain but also has itchiness of her genitals.

Family History: asthma and atopy

Physical Examination: she looks tired

Head and neck exam: normal

Abdomen: soft

Genitourinary exam: no discharge

MSK exam: flat feet 

The remainder of the physical examination is normal. Urine testing shows normal and STI screen is positive.