Differential Diagnosis for a 5-year-old Girl with Urinary Incontinence and Small Leuk and RBC in Urine
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of urinary symptoms in children, including incontinence, and the presence of leukocytes (leuk) and red blood cells (RBC) in the urine supports this diagnosis. UTIs can cause irritation to the bladder and urethra, leading to incontinence.
Other Likely Diagnoses
- Overactive Bladder: This condition can cause urinary incontinence due to an inability to store urine properly in the bladder. While it might not directly cause leuk and RBC in the urine, it's a common cause of incontinence in children.
- Constipation: Chronic constipation can put pressure on the bladder, leading to incontinence. It's a common issue in children and can be associated with urinary symptoms.
- Neurogenic Bladder: Although less common, neurogenic bladder due to spinal cord issues or other neurological problems can cause incontinence. The presence of leuk and RBC might indicate a UTI on top of the underlying condition.
Do Not Miss Diagnoses
- Diabetes Mellitus or Diabetes Insipidus: Both conditions can cause polyuria (excessive urine production), leading to incontinence. Diabetes mellitus can also lead to UTIs, explaining the leuk and RBC in the urine.
- Kidney Stones: While rare in children, kidney stones can cause severe pain, UTIs (explaining the leuk and RBC), and potentially incontinence due to pain or obstruction.
- Spinal Cord Injury or Tumor: Any condition affecting the spinal cord can lead to neurogenic bladder, presenting with incontinence. The presence of leuk and RBC could indicate a complicating UTI.
Rare Diagnoses
- Vesicoureteral Reflux (VUR): A condition where urine flows backward from the bladder into the kidneys, potentially causing UTIs and explaining the leuk and RBC in the urine. It can also lead to incontinence due to bladder dysfunction.
- Urethral Obstruction: Rare in girls, but any obstruction can cause urinary retention, leading to incontinence, and potentially UTIs.
- Exstrophy of the Bladder: A rare congenital anomaly where the bladder is open and turned inside out, which can cause incontinence and is often associated with other urinary tract abnormalities.