Differential Diagnosis for Dysuria, Haematuria, and Fever in a 5-year-old Boy
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of dysuria, haematuria, and fever in children, especially in boys. The symptoms presented are classic for a UTI, and the age of the child increases the likelihood of this diagnosis.
Other Likely Diagnoses
- Kidney Stone: Although less common in children, kidney stones can cause severe pain, dysuria, haematuria, and fever. The presence of haematuria increases the suspicion for a kidney stone.
- Glomerulonephritis: This condition, often post-streptococcal, can present with haematuria, fever, and sometimes dysuria. It's an important consideration in children with these symptoms.
Do Not Miss Diagnoses
- Testicular Torsion: Although it typically presents with acute testicular pain, it can sometimes cause urinary symptoms due to the close anatomical relationship between the testes and the urinary tract. Missing this diagnosis can lead to testicular loss.
- Appendicitis: In some cases, appendicitis can present with urinary symptoms if the appendix is located near the urinary tract. It's crucial to consider this diagnosis to avoid missing a surgical emergency.
- Pyelonephritis: A severe infection of the kidney, pyelonephritis can present with fever, dysuria, and haematuria. It requires prompt antibiotic treatment to prevent long-term kidney damage.
Rare Diagnoses
- Tuberculosis (TB) of the Urinary Tract: Although rare in children, TB can infect the urinary tract and cause chronic symptoms including dysuria, haematuria, and fever.
- Sickle Cell Disease with Urinary Tract Involvement: In children with sickle cell disease, sickling crises can affect the kidneys and cause haematuria, dysuria, and fever.
- Wilms Tumor: A rare kidney cancer in children, Wilms tumor can cause haematuria and sometimes fever, although it's less commonly associated with dysuria.