Differential Diagnosis
- Single most likely diagnosis
- Urinary Tract Infection (UTI): The patient's symptoms of discomfort at the end of urination are consistent with a UTI, which is a common condition, especially in individuals who have been swimming in potentially contaminated water.
- Other Likely diagnoses
- Prostatitis: Given the patient's age and symptoms, prostatitis is a possible diagnosis, especially if the patient has a history of urinary tract issues or has recently engaged in activities that may irritate the prostate.
- Urethritis: This condition, often caused by bacterial or viral infections, can cause discomfort during urination and is a plausible diagnosis given the patient's recent swimming activity.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Schistosomiasis: Although rare, schistosomiasis is a parasitic infection that can be contracted through contaminated water, such as swimming in a dam in Australia where the parasite might be present. It's crucial to consider this diagnosis due to its potential severity and the patient's recent exposure history.
- Gonorrhea or Chlamydia: Despite the patient being married with a single partner, it's essential to consider sexually transmitted infections (STIs) as they can present with similar symptoms and have significant health implications if left untreated.
- Rare diagnoses
- Bladder Cancer: While less likely, bladder cancer can cause symptoms similar to those described, such as discomfort during urination. Given the patient's age, it's a rare but possible diagnosis that should be considered.
- Interstitial Cystitis: This chronic condition causes bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can be similar to those of a UTI but are more persistent and could be considered if other diagnoses are ruled out.