Differential Diagnosis for a 3-month Pregnant Woman with Fever, Chest Congestion, Sore Throat, and Urinalysis Showing Large Leukocytes
- Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of large leukocytes in the urinalysis is highly suggestive of a UTI, which is common in pregnancy due to physiological changes that can predispose women to infection. The symptoms of fever, chest congestion, and sore throat could be secondary to the UTI or a coincidental viral infection.
- Other Likely Diagnoses
- Viral Upper Respiratory Tract Infection: Given the symptoms of fever, chest congestion, and sore throat, a viral upper respiratory tract infection is a plausible diagnosis. The leukocytes in the urine could be a contaminant or indicative of a co-existing UTI.
- Pyelonephritis: Although less common than lower UTIs, pyelonephritis (an infection of the kidney) can occur, especially in pregnancy. It would explain the fever and could be associated with urinary findings, though typically, it presents with more severe symptoms like flank pain.
- Do Not Miss Diagnoses
- Sepsis: Although less likely, sepsis is a potentially life-threatening condition that could arise from an untreated or severe UTI or another infection. The presence of fever and leukocytes, along with any signs of organ dysfunction, would necessitate immediate attention.
- Pneumonia: Given the chest congestion, pneumonia is a critical diagnosis not to miss, as it can be severe in pregnancy and requires prompt antibiotic treatment.
- Rare Diagnoses
- Tuberculosis (TB): Although rare, TB can present with systemic symptoms like fever and can affect the lungs and urinary system. It's essential to consider in high-risk populations or those with exposure history.
- Kidney Stones: While not typically associated with fever and leukocytes unless there's an infection, kidney stones can cause significant pain and could potentially lead to an infection if obstructing urine flow.