Differential Diagnosis for Dysuria with No Pus Cells in Urine but Urine Glucose 3+

Single Most Likely Diagnosis

• Diabetic Ketoacidosis (DKA): The presence of 3+ glucose in the urine, along with dysuria, suggests uncontrolled diabetes mellitus. DKA is a complication of diabetes that can cause dysuria due to the high glucose levels in the urine, which can lead to irritation of the urinary tract.

Other Likely Diagnoses

• Urinary Tract Infection (UTI) with Glucosuria: Although no pus cells are present, UTIs can sometimes present without significant pyuria, especially in the early stages or in patients with diabetes. The high glucose levels could be contributing to the dysuria.
• Diabetes Mellitus: Uncontrolled diabetes can lead to high glucose levels in the urine, causing dysuria. This could be a new diagnosis of diabetes or a complication of existing diabetes.
• Vaginal Infections: In women, vaginal infections such as yeast infections or bacterial vaginosis can cause dysuria without the presence of pus in the urine.

Do Not Miss Diagnoses

• Kidney Stones: Although less common, kidney stones can cause dysuria and may not always present with pus in the urine. The absence of pus does not rule out this diagnosis, and it's crucial to consider due to the potential for severe pain and complications.
• Interstitial Cystitis: A condition that causes bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can mimic those of a UTI without the presence of infection.

Rare Diagnoses

• Tuberculosis of the Urinary Tract: A rare condition that can cause dysuria and may not always present with typical symptoms of a UTI, including pus in the urine.
• Bladder Cancer: Although rare, bladder cancer can cause dysuria. The absence of pus in the urine does not rule out this diagnosis, especially in patients with risk factors such as smoking or exposure to certain chemicals.