Differential Diagnosis for a 3-year-old Boy with Inflamed Foreskin and Dysuria
Single most likely diagnosis
- Balanitis: This is an inflammation of the foreskin and glans penis, common in uncircumcised males. The symptoms of a super inflamed foreskin and soreness during urination align with balanitis, which can be caused by poor hygiene, infection (bacterial, fungal, or viral), or an allergic reaction.
Other Likely diagnoses
- Urinary Tract Infection (UTI): Although less common in boys than girls, UTIs can cause dysuria and might lead to inflammation of the genital area due to irritation.
- Phimosis: This condition, where the foreskin cannot be fully retracted over the glans, can lead to inflammation and infection if not properly managed, presenting with similar symptoms.
- Eczema/Dermatitis: Eczema or dermatitis in the genital area can cause inflammation and discomfort, potentially leading to painful urination if the inflammation is severe.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Sexual Abuse: Although rare and not directly related to the physical symptoms described, it's crucial to consider in the differential diagnosis of any genital trauma or inflammation in children, as it requires immediate intervention.
- Testicular Torsion: While this condition typically presents with acute testicular pain and swelling, any severe genital pain or inflammation in a child warrants consideration of testicular torsion due to its emergency nature.
Rare diagnoses
- Balanoposthitis: An inflammation of both the glans penis and the foreskin, which could be considered a more specific condition related to balanitis but is less commonly discussed as a distinct entity.
- Genital Herpes: A viral infection that can cause painful lesions and inflammation in the genital area, though it's less common in young children without a clear history of exposure.
- Congenital conditions affecting the genitalia: Certain congenital conditions, such as hypospadias or epispadias, can increase the risk of urinary tract issues and genital inflammation, though these would typically be identified earlier in life.