Differential Diagnosis for a 16-year-old Sexually Active Woman with Hematuria, Suprapubic Pain, Dysuria, and Frequency
- Single most likely diagnosis
- Urinary Tract Infection (UTI): This is the most likely diagnosis given the symptoms of dysuria, frequency, suprapubic pain, and hematuria. UTIs are common in sexually active young women, and the presentation is classic for a lower urinary tract infection, such as cystitis.
- Other Likely diagnoses
- Sexually Transmitted Infections (STIs) like Chlamydia or Gonorrhea: These infections can cause symptoms similar to UTIs, including dysuria and pelvic pain. Given the patient's sexual activity, it's essential to consider STIs in the differential diagnosis.
- Kidney Stones: Although less common in this age group, kidney stones can cause severe pain, hematuria, and urinary symptoms. The presence of suprapubic pain could indicate a stone in the lower urinary tract.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pyelonephritis: An upper urinary tract infection that can lead to sepsis if not treated promptly. While the symptoms presented are more suggestive of a lower UTI, pyelonephritis must be considered, especially if the patient has a fever or flank pain.
- Ectopic Pregnancy: Although less likely given the urinary symptoms, an ectopic pregnancy can cause abdominal pain and, in rare cases, hematuria. Given the patient's sexual activity, pregnancy must be ruled out.
- Rare diagnoses
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can overlap with UTIs, but the chronic nature and absence of infection typically distinguish it.
- Glomerulonephritis: An inflammation of the glomeruli in the kidneys, which can cause hematuria. It is less likely given the acute presentation and the presence of dysuria and frequency, which are not typical for glomerulonephritis.
- Tuberculosis of the Urinary Tract: A rare condition in many parts of the world, which can cause chronic symptoms including hematuria, frequency, and pain. It would be considered in patients with risk factors for TB or those who have not responded to standard UTI treatment.