Differential Diagnosis for a 6-year-old Female with Urinary Symptoms
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of blood (+) and protein (+-) in the urine, along with symptoms of frequency and urgency, strongly suggests a UTI. The specific gravity of 1.005 indicates diluted urine, which could be due to increased fluid intake or an attempt by the body to flush out the infection.
Other Likely Diagnoses
- Dehydration: Although the specific gravity is low, which typically indicates diluted urine, the overall clinical picture, including the symptoms of frequency and urgency, could also suggest an element of dehydration, especially if the child has been experiencing increased urine output due to the infection.
- Diabetes Insipidus: The low specific gravity of the urine could also hint at diabetes insipidus, especially with symptoms of frequency and urgency. However, the absence of glucose in the urine makes this less likely, unless it's a case of nephrogenic diabetes insipidus.
Do Not Miss Diagnoses
- Kidney Stone: Although less common in children, a kidney stone could cause blood in the urine and symptoms of urgency and frequency. It's crucial not to miss this diagnosis due to the potential for severe pain and complications.
- Glomerulonephritis: This condition can present with hematuria (blood in urine) and proteinuria (protein in urine) and is a critical diagnosis not to miss due to its implications for kidney function and potential for progression to more severe disease.
Rare Diagnoses
- Alport Syndrome: A genetic disorder characterized by hematuria, proteinuria, and progressive kidney disease. It's rare and typically presents with hearing and vision abnormalities as well.
- Nephrotic Syndrome: Characterized by significant proteinuria, hypoalbuminemia, and edema. It's less likely given the minimal proteinuria (+-) and absence of other symptoms like edema, but it remains a consideration in the differential diagnosis of a child with urinary abnormalities.