Differential Diagnosis for a 13-year-old Male with Fever, Grey Urine, and Pus from the Penis
- Single most likely diagnosis:
- Urinary Tract Infection (UTI) with urethritis: This is likely due to the symptoms of fever, grey urine (indicative of infection), and pus from the penis, which can be a sign of urethral discharge. UTIs are less common in males than females but can occur, especially in the context of an anatomical issue or poor hygiene.
- Other Likely diagnoses:
- Sexually Transmitted Infections (STIs): Given the age and symptoms, STIs such as gonorrhea or chlamydia should be considered, especially if the patient is sexually active. These infections can cause urethritis, leading to discharge and other urinary symptoms.
- Epididymitis: Inflammation of the epididymis, which can be caused by bacterial infection, including STIs or non-sexually transmitted bacteria. Symptoms can include pain, swelling, and discharge.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Testicular torsion: Although this condition typically presents with acute testicular pain and swelling rather than urinary symptoms, it's a surgical emergency that must be ruled out due to the potential for testicular loss.
- Sepsis: If the infection is severe and has entered the bloodstream, it could lead to sepsis, a life-threatening condition that requires immediate medical attention.
- 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 symptoms including urethritis, conjunctivitis, and arthritis.
- Schistosomiasis (bilharzia): A parasitic infection that can cause urinary symptoms, including hematuria and dysuria, though it's more common in specific geographic areas and might not typically present with grey urine or pus from the penis.