Differential Diagnosis for Urine Test Results

The provided urine test results show abnormal findings, including high leukocytes, nitrite-negative, and rare bacteria. Based on these results, the following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Urinary Tract Infection (UTI): The presence of high leukocytes (75 WBCs/mcL) and rare bacteria in the urine suggests a UTI. The symptoms and test results are consistent with a bacterial infection of the urinary tract.
• Other Likely Diagnoses
  • Dehydration: The specific gravity of the urine is 1.022, which is within the normal range but on the higher side. This could indicate dehydration, which may contribute to the concentration of the urine and the presence of abnormal findings.
  • Kidney Stone: The presence of 7 RBCs/HPF and 8 WBCs/HPF could indicate a kidney stone, which may cause inflammation and bleeding in the urinary tract.
• Do Not Miss Diagnoses
  • Pyelonephritis: Although the nitrite test is negative, pyelonephritis (a bacterial infection of the kidney) is a potentially life-threatening condition that should not be missed. The presence of high leukocytes and rare bacteria in the urine warrants further investigation to rule out pyelonephritis.
  • Sepsis: If the UTI is not properly treated, it can lead to sepsis, a life-threatening condition that requires immediate medical attention.
• Rare Diagnoses
  • Interstitial Nephritis: This is a rare condition characterized by inflammation of the kidney tissue. The presence of high leukocytes and rare bacteria in the urine could be indicative of interstitial nephritis, although it is less likely.
  • Tubulointerstitial Disease: This is a group of rare diseases that affect the tubules and interstitium of the kidney. The abnormal urine test results could be indicative of tubulointerstitial disease, although further testing would be required to confirm the diagnosis.