Differential Diagnosis
- Single most likely diagnosis + Urinary Tract Infection (UTI): The presence of moderate blood, protein, and RBCs in the urine, along with moderate bacteria, strongly suggests a UTI. The elevated CRP (41.2) also indicates an infectious or inflammatory process, which is consistent with a UTI.
- Other Likely diagnoses + Sepsis: The elevated CRP and the presence of bands (immature white blood cells) in the CBC suggest a possible infectious process that could be systemic, such as sepsis. However, the absence of more specific symptoms or vital sign abnormalities makes this less likely than a localized UTI. + Pyelonephritis: This is an infection of the kidney, which could explain the findings in the UA and the elevated CRP. It is often associated with UTIs and could be a possible diagnosis, especially if the patient has symptoms such as flank pain or fever.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Sepsis due to a different source (e.g., pneumonia, intra-abdominal infection): Although the UA suggests a UTI, it's crucial to consider other potential sources of sepsis, as the consequences of missing such a diagnosis could be fatal. + Kidney stones with infection: If the patient has a kidney stone that is obstructing the flow of urine, it could lead to an infection, which might present similarly to a UTI or pyelonephritis.
- Rare diagnoses + Glomerulonephritis: This is an inflammation of the glomeruli, the filtering units of the kidneys. It could explain the hematuria (blood in the urine) and proteinuria (protein in the urine), but it would not typically cause bacteriuria (bacteria in the urine). + Interstitial nephritis: This is an inflammation of the spaces between the renal tubules. It could be caused by an infection, but it's less likely given the presence of moderate bacteria in the urine, which suggests a more typical UTI.