Differential Diagnosis for a 57-year-old Caucasian Man with Dysuria and Blood Clots in Urine
Single Most Likely Diagnosis
- Bladder Cancer: This is a common cause of hematuria (blood in urine) in older adults, especially in men. The presence of blood clots in the urine increases the suspicion for a bladder or urinary tract malignancy.
Other Likely Diagnoses
- Benign Prostatic Hyperplasia (BPH): Enlargement of the prostate gland can cause urinary retention, leading to bleeding and clot formation. This condition is common in older men.
- Urinary Tract Infection (UTI): Although less common in men, UTIs can cause dysuria (painful urination) and hematuria. The presence of blood clots might suggest a more severe infection.
- Kidney Stones: Stones in the urinary tract can cause severe pain, dysuria, and hematuria. The blood clots could be a result of the stone causing trauma to the urinary tract lining.
Do Not Miss Diagnoses
- Sepsis due to UTI: If the UTI is severe and has progressed to sepsis, it could be life-threatening. Early recognition and treatment are crucial.
- Renal Cell Carcinoma: Although less common than bladder cancer, renal cell carcinoma can also present with hematuria and should not be missed due to its potential for metastasis.
Rare Diagnoses
- Sickle Cell Disease or Sickle Cell Trait: These conditions can cause hematuria due to sickling of red blood cells in the low-oxygen environment of the kidneys.
- Goodpasture Syndrome: A rare autoimmune disease that can cause glomerulonephritis and hematuria.
- Schistosomiasis: A parasitic infection that can cause bladder and urinary tract symptoms, including hematuria, although it is rare in non-endemic areas without travel history.