Differential Diagnosis for a 2-year-old Boy with Dysuria
- Single most likely diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of dysuria in children, especially in those who are toilet-trained or are in the process of toilet training. The symptoms of UTI can include dysuria, frequency, urgency, and sometimes fever.
- Other Likely diagnoses
- Phimosis: In young boys, a tight foreskin can cause dysuria due to narrowing of the urethral meatus, leading to obstructed urine flow.
- Urethral stricture or meatal stenosis: These conditions can cause narrowing of the urethra, leading to obstructed urine flow and dysuria.
- Constipation: Although not directly related to the urinary system, constipation can cause urinary symptoms, including dysuria, due to the proximity of the rectum to the bladder and urethra.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Posterior Urethral Valves (PUV): A congenital condition that can cause obstructive uropathy, leading to recurrent UTIs, dysuria, and potentially severe kidney damage if not diagnosed and treated promptly.
- Testicular torsion: Although more commonly associated with acute testicular pain, testicular torsion can sometimes present with urinary symptoms, including dysuria, due to the shared innervation of the testes and urinary tract.
- Epididymitis: Inflammation of the epididymis can cause dysuria, along with testicular pain and swelling.
- Rare diagnoses
- Urethral foreign body: Insertion of a foreign body into the urethra can cause dysuria, along with other urinary symptoms.
- Interstitial cystitis: A condition characterized by chronic inflammation of the bladder wall, leading to dysuria, frequency, and urgency.
- Neurogenic bladder: A condition resulting from a neurological condition affecting bladder control, which can cause a range of urinary symptoms, including dysuria.