Differential Diagnosis
The patient's urinalysis and laboratory results suggest a urinary tract issue. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Urinary Tract Infection (UTI): The presence of WBCs (6-10/hpf), few bacteria, and trace leukocyte esterase in the urinalysis supports this diagnosis. The patient's symptoms and lab results are consistent with a mild to moderate UTI.
- Other Likely diagnoses
- Chronic Kidney Disease (CKD): The elevated creatinine level (1.53) and decreased eGFR (46) indicate impaired kidney function, which may be a contributing factor to the patient's symptoms.
- Dehydration: The patient's laboratory results do not specifically indicate dehydration, but it could be a contributing factor to the concentrated urine and elevated creatinine level.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although the patient's CBC shows a relatively normal white blood cell count, the presence of bacteria in the urine and impaired kidney function increases the risk of sepsis, particularly if the infection spreads.
- Pyelonephritis: The patient's symptoms and laboratory results could be indicative of pyelonephritis, a kidney infection that requires prompt treatment to prevent serious complications.
- Kidney Stone: The presence of RBCs (3-5/hpf) in the urine could suggest a kidney stone, which may cause obstruction and lead to severe consequences if not addressed.
- Rare diagnoses
- Glomerulonephritis: The patient's laboratory results, including the presence of RBCs and WBCs in the urine, could be indicative of glomerulonephritis, an inflammatory kidney disease.
- Interstitial Nephritis: The patient's elevated creatinine level and decreased eGFR may be suggestive of interstitial nephritis, a condition characterized by inflammation of the kidney tissue.