Differential Diagnosis
The patient's presentation is complex, with abnormal urinalysis and CBC results, as well as an elevated creatinine level. Here are the potential diagnoses, categorized for clarity:
- Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of WBCs, RBCs, bacteria, and leukocyte esterase in the urinalysis suggests a UTI. The patient's symptoms and lab results are consistent with this diagnosis.
- Other Likely Diagnoses
- Chronic Kidney Disease (CKD): The elevated creatinine level and decreased eGFR indicate impaired kidney function, which may be due to CKD.
- Dehydration: The patient's lab results do not show significant electrolyte imbalances, but dehydration could contribute to the elevated creatinine level.
- Pyelonephritis: The presence of WBCs and RBCs in the urinalysis, along with the patient's symptoms, could suggest pyelonephritis, an infection of the kidney.
- Do Not Miss Diagnoses
- Sepsis: Although the patient's CBC results do not show significant abnormalities, the presence of bacteria in the urinalysis and the elevated creatinine level could indicate a systemic infection.
- Kidney Stones: The patient's symptoms and lab results could be consistent with kidney stones, which would require prompt medical attention.
- Glomerulonephritis: The presence of RBCs and WBCs in the urinalysis could suggest an inflammatory process, such as glomerulonephritis.
- Rare Diagnoses
- Interstitial Nephritis: The patient's symptoms and lab results could be consistent with interstitial nephritis, an inflammatory process affecting the kidney tissue.
- Vasculitis: The presence of RBCs and WBCs in the urinalysis, along with the patient's symptoms, could suggest a vasculitic process affecting the kidneys.
- Malignancy: Although unlikely, the patient's symptoms and lab results could be consistent with a malignancy, such as bladder or kidney cancer.