Differential Diagnosis for Black Semen and Itchiness in a 62-year-old Male
Single Most Likely Diagnosis
- Hematospermia with prostatitis or seminal vesiculitis: This condition, characterized by the presence of blood in the semen, can cause the semen to appear black or dark brown. Prostatitis or seminal vesiculitis, which are infections or inflammations of the prostate or seminal vesicles, respectively, can lead to hematospermia and are common causes of itchy sensations in the genital area.
Other Likely Diagnoses
- Schistosomiasis: A parasitic infection that can cause hematospermia and is associated with itching and other urinary symptoms.
- Urethritis: Inflammation of the urethra, which can cause discharge, itching, and potentially hematospermia if the infection involves the seminal vesicles or prostate.
- Prostate cancer: Although less common, prostate cancer can cause hematospermia, and while it might not directly cause itching, associated conditions like prostatitis could.
Do Not Miss Diagnoses
- Testicular cancer: While rare, testicular cancer can cause changes in semen appearance and should not be missed due to its potential severity and the importance of early detection.
- Genitourinary tuberculosis: A rare condition in many parts of the world but can cause a wide range of symptoms including hematospermia, itching, and systemic illness.
Rare Diagnoses
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can rarely affect the genital tract and cause hematospermia.
- Malacoplakia: A rare inflammatory condition that can affect the genitourinary system and cause a variety of symptoms, including hematospermia.
- Spermatocele or epididymal cyst with hemorrhage: While typically benign, these conditions can rarely cause hematospermia if there is bleeding into the cyst.