Differential Diagnosis for Dysuria with a Sterile Urine Culture
- Single Most Likely Diagnosis
- Urethral syndrome: This condition is characterized by symptoms of a urinary tract infection (UTI) such as dysuria, frequency, and urgency, but with a negative urine culture. It is often related to urethral irritation or inflammation.
- Other Likely Diagnoses
- Overactive bladder: This condition can cause urinary frequency, urgency, and dysuria, even in the absence of a UTI.
- Interstitial cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can lead to dysuria.
- Vaginitis or vulvitis: Inflammation of the vagina or vulva can cause dysuria due to external irritation.
- Prostatitis: Inflammation of the prostate gland can cause dysuria in men.
- Do Not Miss Diagnoses
- Tuberculosis of the urinary tract: Although rare, it can cause chronic dysuria and sterile urine cultures due to the fastidious nature of the organism.
- Malignancy of the urinary tract: Tumors in the bladder, ureters, or kidneys can cause dysuria and may not always be associated with infection.
- Kidney stones: While often associated with infection, stones can cause dysuria without infection, especially if they are obstructing urine flow.
- Rare Diagnoses
- Sjögren's syndrome: An autoimmune disorder that can cause interstitial cystitis and dysuria.
- Eosinophilic cystitis: A rare condition characterized by eosinophilic infiltration of the bladder wall, leading to dysuria and other urinary symptoms.
- Radiation cystitis: Inflammation of the bladder due to radiation therapy, which can cause dysuria.
- Chemical cystitis: Exposure to certain chemicals can cause bladder inflammation and dysuria.