Differential Diagnosis for Female UTI
When developing a differential diagnosis for a female urinary tract infection (UTI), it's essential to consider the most common microbes involved. The following categories outline the potential diagnoses:
- Single most likely diagnosis
- Escherichia coli (E. coli): This bacterium is responsible for approximately 75-90% of uncomplicated UTIs in women, making it the most likely cause.
- Other Likely diagnoses
- Staphylococcus saprophyticus: This bacterium is the second most common cause of UTIs in women, particularly in those who are sexually active.
- Klebsiella pneumoniae: This bacterium can cause UTIs, especially in women with underlying medical conditions or those who have undergone instrumentation of the urinary tract.
- Enterococcus faecalis: This bacterium can cause UTIs, particularly in women with underlying medical conditions or those who have been hospitalized.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pseudomonas aeruginosa: Although less common, this bacterium can cause severe UTIs, especially in women with compromised immune systems or underlying medical conditions.
- Candida species: Fungal UTIs can occur, especially in women with diabetes, immunocompromised states, or those who have been using catheters.
- Mycobacterium tuberculosis: Although rare, tuberculosis can infect the urinary tract, and it's essential to consider this diagnosis in women with risk factors, such as exposure to TB or immunocompromised states.
- Rare diagnoses
- Proteus mirabilis: This bacterium can cause UTIs, especially in women with underlying medical conditions or those who have undergone instrumentation of the urinary tract.
- Citrobacter species: These bacteria can cause UTIs, although they are relatively rare.
- Aerococcus urinae: This bacterium is a rare cause of UTIs, but it's essential to consider it in women with underlying medical conditions or those who have been hospitalized.
Justification for each diagnosis is based on the frequency of occurrence, patient demographics, and underlying medical conditions. It's crucial to consider these factors when developing a differential diagnosis for female UTI to ensure accurate diagnosis and effective treatment.