Differential Diagnosis for Male Patient with Urinary Discomfort and Genital Irritation

Single Most Likely Diagnosis

• Prostatitis: This condition is characterized by inflammation of the prostate gland and can cause urinary discomfort, low-grade fevers, chills, and penile discomfort. The absence of dysuria, discharge, or visible changes does not rule out prostatitis, especially the non-bacterial or chronic form, which can present with subtle symptoms.

Other Likely Diagnoses

• Urethritis: Although the patient denies discharge, urethritis (inflammation of the urethra) can cause genital irritation and discomfort. It's often associated with sexually transmitted infections (STIs) but can also be non-infectious.
• Urinary Tract Infection (UTI): While the patient does not report dysuria, UTIs can present with mild symptoms, especially in men. The recent elevated blood pressure readings could be coincidental or related to discomfort or pain.
• Epididymitis: Inflammation of the epididymis (the tube behind the testicle that stores and carries sperm) can cause testicular pain, which might radiate to the penis, and could be associated with mild urinary symptoms.

Do Not Miss Diagnoses

• Testicular Torsion: Although this condition typically presents with acute, severe testicular pain, it's a medical emergency that requires prompt intervention. Missing this diagnosis could result in loss of the testicle.
• Kidney Stone: While the patient does not report severe pain or flank pain, kidney stones can sometimes present with mild or atypical symptoms, especially if the stone is small or not obstructing the ureter.
• Severe Infection (e.g., Sepsis): Any infection that progresses to sepsis is life-threatening. The presence of low-grade fevers and chills, even with mild urinary symptoms, warrants consideration of a severe infection, especially in the context of recent elevated blood pressure readings.

Rare Diagnoses

• Reiter's Syndrome (Reactive Arthritis): A form of arthritis that occurs as a reaction to an infection elsewhere in the body, often in the gastrointestinal tract or the urethra. It can cause urethritis, conjunctivitis, and arthritis, among other symptoms.
• Genital Herpes: Could cause genital irritation and discomfort, though typically associated with vesicular lesions.
• Tuberculosis of the Genitourinary Tract: A rare condition in many parts of the world but can cause chronic urinary symptoms, including discomfort and irritation, along with systemic symptoms like fevers and chills.