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 suggests a significant source of bleeding, which could be a tumor in the bladder.
- Other Likely diagnoses
- Kidney stones: Stones in the urinary tract can cause severe pain, dysuria, and bleeding. The blood clots could be a result of the stone causing trauma to the urinary tract lining.
- Prostate cancer: Although less likely than bladder cancer to present with hematuria, prostate cancer can cause urinary symptoms, including dysuria and bleeding, especially in older men.
- Benign prostatic hyperplasia (BPH): An enlarged prostate can cause urinary retention, leading to bleeding and clot formation.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis from a urinary tract infection: Although less common, a severe urinary tract infection can lead to sepsis, a life-threatening condition. The presence of dysuria and hematuria could be indicative of an infection.
- Renal vein thrombosis: This is a rare but potentially life-threatening condition that can cause hematuria and flank pain. It is more common in patients with nephrotic syndrome or other hypercoagulable states.
- Rare diagnoses
- Schistosomiasis: A parasitic infection that can cause bladder symptoms, including hematuria, although it is rare in the United States.
- Tuberculosis of the urinary tract: A rare infection that can cause hematuria, dysuria, and other urinary symptoms.
- Arteriovenous malformation or fistula: A rare vascular anomaly that can cause bleeding in the urinary tract.