Differential Diagnosis

The patient presents with symptoms of burning while urinating, lower back pain, and elevated blood pressure. The following differential diagnosis is organized into categories:

• Single Most Likely Diagnosis
  • Urinary Tract Infection (UTI): The patient's symptoms of burning while urinating and lower back pain are classic for a UTI. The elevated blood pressure could be unrelated or potentially exacerbated by the pain and discomfort.
• Other Likely Diagnoses
  • Pyelonephritis: An infection of the kidney, which could explain the lower back pain and burning urination. The elevated blood pressure could be a response to the infection.
  • Kidney Stone: A possible cause of the lower back pain and burning urination, although the absence of severe colicky pain makes this less likely.
  • Uncontrolled Hypertension: The patient's elevated blood pressure and admission of not taking her medication could indicate uncontrolled hypertension, which may be contributing to her symptoms.
• Do Not Miss Diagnoses
  • Sepsis: Although less likely, sepsis due to a UTI or pyelonephritis could be life-threatening if missed. The patient's symptoms and elevated blood pressure warrant consideration of this diagnosis.
  • Kidney Injury or Infarction: A potential cause of the patient's symptoms, especially if she has a history of uncontrolled hypertension or other underlying conditions.
• Rare Diagnoses
  • Interstitial Cystitis: A chronic condition that could cause burning urination, but it is less likely given the acute onset of symptoms.
  • Tubulointerstitial Nephritis: A rare condition that could cause lower back pain and burning urination, but it is less likely without other supporting symptoms or laboratory findings.