Differential Diagnosis for Penile Pain and Urinary Symptoms
The patient's symptoms of penile pain with erection, occasional burning with urination, urinary urgency, body aches, and chills can be attributed to various causes. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Urethritis: This condition, often caused by sexually transmitted infections (STIs) like gonorrhea or chlamydia, or by other pathogens, aligns closely with the patient's symptoms. The presence of penile pain during erection, dysuria (painful urination), and urinary urgency are common presentations of urethritis.
Other Likely Diagnoses
- Prostatitis: Inflammation of the prostate gland can cause urinary urgency, frequency, and pain, as well as body aches and chills. It might also lead to painful erections.
- Urinary Tract Infection (UTI): While UTIs are more common in women, men can also develop them, especially if they have an underlying condition like an enlarged prostate. Symptoms can include dysuria, urinary urgency, and frequency.
- Epididymitis: Inflammation of the epididymis, often due to bacterial infection, can cause testicular pain that might radiate to the penis, along with urinary symptoms.
Do Not Miss Diagnoses
- Testicular Torsion: Although it typically presents with sudden, severe testicular pain and might not fully align with the patient's symptoms, it's a medical emergency that requires immediate attention. Delayed diagnosis can lead to testicular loss.
- Kidney Stones: While the patient denies flank pain, small stones might not cause the typical severe flank pain. However, they can still cause urinary urgency, frequency, and dysuria.
- Septicemia: The presence of body aches, chills, and potential urinary infection sources (like prostatitis or epididymitis) raises the concern for sepsis, especially if the infection spreads systemically.
Rare Diagnoses
- Peyronie's Disease: This condition involves the development of scar tissue inside the penis, leading to curved, painful erections. However, it doesn't typically cause urinary symptoms.
- Penile Cancer: Although extremely rare and unlikely without other specific symptoms like a penile mass or ulcer, it should be considered in the differential diagnosis of penile pain, especially if other causes are ruled out.
- Reiter's Syndrome (Reactive Arthritis): A form of arthritis that occurs as a reaction to a bacterial infection, often in the genital or gastrointestinal tract. It can cause urethritis, conjunctivitis, and arthritis, among other symptoms.