Differential Diagnosis for Male with Dysuria
Single Most Likely Diagnosis
- Urethritis due to Chlamydia or Gonorrhea: These sexually transmitted infections (STIs) are common causes of dysuria in men, especially in the absence of leukocytes. The presence of slight glucose and trace blood can be seen in these conditions due to the inflammation of the urethral mucosa.
Other Likely Diagnoses
- Urethral Stricture: This condition can cause dysuria due to obstruction of the urethral lumen, and the presence of trace blood may indicate urethral trauma or inflammation.
- Prostatitis: Although less common without leukocytes, chronic prostatitis can cause dysuria, and the presence of glucose and blood may be seen in some cases.
- Urethritis due to Ureaplasma or Mycoplasma: These organisms can cause urethritis with minimal or no leukocyte response, and the symptoms can be similar to those of Chlamydia or Gonorrhea.
Do Not Miss Diagnoses
- Kidney Stone: Although less likely, a kidney stone can cause dysuria, and the presence of blood in the urine (hematuria) is a key finding. Missing this diagnosis could lead to severe pain, infection, or kidney damage if not promptly treated.
- Tuberculosis (TB) of the Urinary Tract: TB can cause dysuria, hematuria, and sterile pyuria (absence of leukocytes). Although rare, missing this diagnosis could lead to severe consequences, including kidney damage and spread of the disease.
Rare Diagnoses
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can include dysuria, but it is less common in men.
- Schistosomiasis: A parasitic infection that can cause hematuria and dysuria, but it is rare in areas without endemic disease.
- Malignancy of the Urinary Tract: Although very rare, malignancies such as bladder or urethral cancer can cause dysuria and hematuria. These conditions are more common in older men and those with risk factors such as smoking.