Differential Diagnosis for a 2-year-old Boy with Penile Pain, Worsened by Urination
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is a common condition in young children that can cause pain in the genital area, especially during urination. The symptoms of UTI, such as dysuria (painful urination), frequency, and urgency, align closely with the presentation described.
Other Likely Diagnoses
- Phimosis: Inflammation or narrowing of the foreskin can cause pain, especially during urination, and is common in uncircumcised males.
- Balanitis: Inflammation of the glans penis, often due to infection or poor hygiene, can cause pain and discomfort.
- Urethral Stricture or Meatal Stenosis: Narrowing of the urethra or the external urethral meatus can cause obstructive symptoms and pain during urination.
Do Not Miss Diagnoses
- Testicular Torsion: Although more commonly associated with acute testicular pain, it's a surgical emergency that can sometimes present with radiating pain to the penis or groin area.
- Epispadias or Hypospadias Complications: Congenital anomalies of the penis can lead to urinary tract issues, including obstruction and infection, which might cause penile pain.
- Sexual Abuse: A critical consideration in any child presenting with genital pain or trauma, requiring a sensitive and thorough evaluation.
Rare Diagnoses
- Henoch-Schönlein Purpura (HSP): A systemic vasculitis that can rarely cause genital manifestations, including pain and swelling.
- Behçet's Disease: A rare condition characterized by recurrent oral and genital ulcers, which might cause penile pain in rare cases.
- Fixed Drug Eruption: A rare skin condition that can cause lesions and pain in the genital area in response to certain medications.