Differential Diagnosis
- Single most likely diagnosis
- Urinary Tract Infection (UTI): The patient's symptoms of dysuria (pain at the end of urination) are classic for a UTI, which is a common condition, especially in women. The fact that the patient is 40 years old and has been married with a single partner for a long time reduces the likelihood of a sexually transmitted infection (STI), making UTI a more probable diagnosis.
- Other Likely diagnoses
- Prostatitis: Although the patient is a woman, prostatitis is not exclusive to men, and some women have a Skene's gland that can become inflamed, leading to similar symptoms.
- Interstitial Cystitis: This condition is characterized by chronic pain in the bladder and pelvic region, and could be considered given the patient's symptoms of pain at the end of urination.
- Urethral Syndrome: This condition is characterized by symptoms of dysuria, frequency, and urgency, without evidence of a UTI, and could be a possible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Kidney Stone: Although the patient does not have the classic symptoms of a kidney stone (severe pain, nausea, vomiting), it is essential to consider this diagnosis, as a kidney stone can cause severe pain and potentially life-threatening complications if left untreated.
- Septicemia: If the patient's symptoms are due to an infection, there is a risk of septicemia, which can be life-threatening if not promptly treated.
- Rare diagnoses
- Schistosomiasis: Given the patient's recent travel history to Australia, where they swam in a dam, it is possible that they were exposed to Schistosoma parasites, which can cause urinary symptoms.
- Tuberculosis (TB) of the Urinary Tract: Although rare, TB can affect the urinary tract and cause symptoms similar to those experienced by the patient.