Differential Diagnosis for a 68-year-old Male with Urinary Symptoms
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The patient's symptoms of fever, urinary frequency, and dysuria are classic for a UTI. The resolution of fever but persistence of dysuria suggests a possible lower urinary tract infection, such as cystitis.
Other Likely Diagnoses
- Prostatitis: Given the patient's age and symptoms, prostatitis is a possible diagnosis. The dysuria and urinary frequency could be indicative of an inflamed prostate.
- Benign Prostatic Hyperplasia (BPH): BPH can cause urinary frequency and dysuria, especially in older men. While it may not directly cause fever, it could contribute to urinary stasis, increasing the risk of UTI.
- Overactive Bladder: This condition could explain the urinary frequency, but it would not typically cause fever or significant dysuria.
Do Not Miss Diagnoses
- Kidney Stones: Although the patient's symptoms have partially resolved, kidney stones could cause severe pain, fever, and urinary symptoms. Missing this diagnosis could lead to severe complications, such as obstructive uropathy or sepsis.
- Pyelonephritis: An upper urinary tract infection could present with similar symptoms and would require prompt antibiotic treatment to prevent complications like sepsis or kidney damage.
- Prostate Cancer: While less likely to present with acute urinary symptoms, prostate cancer is a consideration in older men and could be associated with obstructive urinary symptoms.
Rare Diagnoses
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can mimic those of a UTI but are typically more chronic.
- Tuberculosis of the Urinary Tract: A rare infection that could cause chronic urinary symptoms, including frequency and dysuria, along with systemic symptoms like fever and weight loss.
- Bladder Cancer: Could present with urinary symptoms, including frequency and dysuria, especially in older adults with a history of smoking.