What are the causes of hematuria (presence of blood in urine) with pyuria (presence of pus in urine) in an adolescent?

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Differential Diagnosis for Cloudy Bloody Urine in a Teenager

  • Single Most Likely Diagnosis
    • Urinary Tract Infection (UTI): This is the most common cause of cloudy and bloody urine in teenagers, especially in females. The presence of bacteria, such as E. coli, can cause inflammation and lead to hematuria (blood in the urine) and pyuria (pus in the urine).
  • Other Likely Diagnoses
    • Kidney Stones: Teenagers can develop kidney stones, which can cause severe pain, hematuria, and cloudy urine due to the obstruction and inflammation caused by the stone.
    • Glomerulonephritis: This is an inflammation of the glomeruli, the filtering units of the kidneys, which can be caused by infections, autoimmune disorders, or other factors. It can lead to hematuria, proteinuria, and cloudy urine.
    • Trauma: Blunt or penetrating trauma to the kidneys or urinary tract can cause hematuria and cloudy urine.
  • Do Not Miss Diagnoses
    • Sickle Cell Disease or Sickle Cell Trait with Sickle Cell Nephropathy: This condition can cause hematuria, proteinuria, and renal failure due to the sickling of red blood cells in the kidneys.
    • Alport Syndrome: A genetic disorder that affects the type IV collagen in the kidneys, leading to hematuria, proteinuria, and progressive renal failure.
    • Wilms Tumor: A rare type of kidney cancer that can cause hematuria, abdominal mass, and cloudy urine.
  • Rare Diagnoses
    • Goodpasture Syndrome: A rare autoimmune disorder that causes inflammation in the kidneys and lungs, leading to hematuria, proteinuria, and renal failure.
    • Hemolytic Uremic Syndrome (HUS): A rare condition that causes hemolytic anemia, thrombocytopenia, and renal failure, often associated with E. coli infections.
    • Cystic Kidney Diseases (e.g., Autosomal Dominant Polycystic Kidney Disease): Rare genetic disorders that can cause cysts to form in the kidneys, leading to hematuria, proteinuria, and renal failure.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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