You are dispatched to an apartment complex for a 20-year-old woman who is sick. What should you suspect if she reports a purulent vaginal discharge without fever?

In the scenario presented, the symptom of purulent vaginal discharge without a fever is indicative of a sexually transmitted infection (STI), and gonorrhea is a common cause of such a discharge. Gonorrhea is characterized by its purulent (pus-like) discharge and can occur in women without systemic symptoms such as fever. The absence of fever suggests that the infection has not progressed to a more severe systemic condition.

Gonorrhea often presents with symptoms such as dysuria, increased vaginal discharge, and vaginal itching, aligning closely with the reported symptom of purulent discharge. Additionally, it can occasionally present without any other accompanying symptoms, especially in the earlier stages.

In contrast, syphilis typically does not present with purulent discharge but instead manifests through sores or rashes, which may not correlate with the given symptoms. Genital herpes usually presents with painful sores and lesions rather than a purulent discharge, and pelvic inflammatory disease often includes fever and severe pelvic or abdominal pain along with abnormal discharge, which does not match the symptoms described.