Differential Diagnosis for a 35-year-old Female with Urinary Symptoms
Single Most Likely Diagnosis
- Uncomplicated Urinary Tract Infection (UTI): The patient's symptoms of urinary frequency, urgency, dysuria, suprapubic pressure, and lower back discomfort are classic for a UTI. Her past medical history of UTIs also supports this diagnosis.
Other Likely Diagnoses
- Interstitial Cystitis: This condition is characterized by chronic bladder pressure, bladder pain, and sometimes pelvic pain. The patient's symptoms of suprapubic pressure and dysuria could be consistent with interstitial cystitis, especially given her history of UTIs.
- Overactive Bladder: The patient's symptoms of urinary frequency and urgency could be indicative of overactive bladder, a condition characterized by a sudden urge to urinate.
- Kidney Stone: Although the patient denies any nausea, vomiting, or fever, her history of kidney stones and current symptoms of lower back discomfort and dysuria could suggest a possible kidney stone.
Do Not Miss Diagnoses
- Pyelonephritis: Although the patient denies any fever or chills, pyelonephritis (a kidney infection) is a serious condition that can present with symptoms similar to a UTI. It is crucial to consider this diagnosis, especially given her history of UTIs and kidney stones.
- Sepsis: If the patient's UTI or other infection were to progress to sepsis, it could be life-threatening. Although she denies any systemic symptoms, it is essential to be vigilant for signs of sepsis.
- Pulmonary Embolism (PE): Given the patient's history of PE, it is crucial to consider this diagnosis, especially if she reports any respiratory symptoms or chest pain.
Rare Diagnoses
- Bladder Cancer: Although rare in a 35-year-old female, bladder cancer can present with symptoms similar to a UTI, such as dysuria and hematuria.
- Tuberculosis (TB) of the Urinary Tract: TB can infect the urinary tract and present with symptoms similar to a UTI, such as dysuria and frequency. However, this diagnosis is relatively rare in the general population.