Differential Diagnosis for Dysuria in a 9-year-old Boy
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of dysuria in children, and boys are more likely to experience UTIs at a younger age. The symptoms of UTI, such as pain or burning during urination, frequent urination, and abdominal pain, align with the presentation of dysuria.
Other Likely Diagnoses
- Urethritis: Inflammation of the urethra can cause dysuria, and it is often associated with a discharge or other urinary symptoms.
- Constipation: Constipation can cause urinary retention and subsequent dysuria due to the proximity of the rectum to the urethra and bladder.
- Overactive Bladder: This condition can lead to urinary frequency, urgency, and dysuria due to the bladder's inability to hold urine properly.
Do Not Miss Diagnoses
- Kidney Stones: Although less common in children, kidney stones can cause severe pain and dysuria. Missing this diagnosis could lead to complications such as kidney damage or obstruction.
- Posterior Urethral Valves: A congenital condition that can cause urinary obstruction, leading to dysuria, urinary retention, and other complications. Early diagnosis is crucial to prevent long-term damage.
- Sexual Abuse: In some cases, dysuria in a child can be a sign of sexual abuse. It is essential to consider this possibility and perform a thorough evaluation to ensure the child's safety.
Rare Diagnoses
- Interstitial Cystitis: A chronic condition that causes bladder pressure, pain, and sometimes dysuria. It is rare in children but should be considered if other diagnoses are ruled out.
- Tuberculosis of the Urinary Tract: Although rare, tuberculosis can affect the urinary tract and cause dysuria, among other symptoms. This diagnosis should be considered in children with risk factors for tuberculosis exposure.
- Sickle Cell Disease: In children with sickle cell disease, dysuria can be a symptom of a sickle cell crisis affecting the kidneys or urinary tract.