What is the diagnosis for a patient presenting with symptoms of a urinary tract infection (UTI), including vaginal pruritus, dysuria, urinary frequency, metrorrhagia, and leukorrhea, accompanied by lower abdominal pain?

Differential Diagnosis for Urinary Tract Infection (UTI) Symptoms

Single Most Likely Diagnosis

• Urinary Tract Infection (UTI): The patient's symptoms of painful urination, urinary frequency, and lower abdominal pain are classic for a UTI. The presence of vaginal itchiness and discharge could be related to a concurrent vaginal infection, but the primary symptoms suggest a UTI.

Other Likely Diagnoses

• Vaginal Yeast Infection: The patient's complaint of vaginal itchiness and discharge could indicate a vaginal yeast infection, which is common in women and can cause significant discomfort.
• Bacterial Vaginosis: Similar to a yeast infection, bacterial vaginosis can cause vaginal discharge and itchiness, and it's possible that the patient has a vaginal infection rather than or in addition to a UTI.
• Sexually Transmitted Infection (STI): The patient's symptoms of vaginal discharge and spotting could be indicative of an STI, such as chlamydia or gonorrhea, which can cause similar symptoms to a UTI.

Do Not Miss Diagnoses

• Ectopic Pregnancy: Although the patient does not mention missing a period or having a positive pregnancy test, ectopic pregnancy can present with lower abdominal pain, spotting, and urinary symptoms, making it a critical diagnosis not to miss.
• Appendicitis: Appendicitis can cause lower abdominal pain, which could be referred to the suprapubic area, and urinary symptoms if the appendix is located near the bladder or ureter.
• Pelvic Inflammatory Disease (PID): PID is a serious infection of the female reproductive organs that can cause lower abdominal pain, vaginal discharge, and urinary symptoms, and it requires prompt treatment to prevent long-term complications.

Rare Diagnoses

• Interstitial Cystitis: A chronic condition that causes bladder pressure, bladder pain, and sometimes pelvic pain, which could be considered if the patient's symptoms persist despite treatment for a UTI.
• Endometriosis: A condition in which tissue similar to the lining of the uterus grows outside the uterus, causing pelvic pain, which could be considered if the patient's symptoms are recurrent and related to her menstrual cycle.