Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: October 14, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Lower Back Pain with Burning Urination and a Rash

Single Most Likely Diagnosis

  • Urinary Tract Infection (UTI) with associated back pain and rash: This could be a simple UTI causing dysuria (burning urination) and lower back pain due to pyelonephritis (infection of the kidney), with a rash potentially being unrelated or a reaction to an antibiotic.

Other Likely Diagnoses

  • Pyelonephritis: An infection of the kidney, which can cause lower back pain (flank pain), burning urination, and potentially a rash if there's an allergic reaction to an antibiotic or if the infection leads to sepsis.
  • Herpes Zoster (Shingles): Can cause a rash and severe pain, including lower back pain if the affected dermatome is in the lower thoracic or upper lumbar region. Burning urination could be due to involvement of the nerves affecting the bladder.
  • Intermittent Porphyria: Though less common, this condition can cause abdominal and lower back pain, neurological symptoms, and sometimes a rash. Urinary symptoms can also occur due to the neurological effects of the disease.

Do Not Miss Diagnoses

  • Spinal Epidural Abscess: A serious condition that can cause back pain, neurological deficits, and if the abscess presses on nerves that control bladder function, could potentially cause urinary retention or burning urination. A rash might not be directly related but could be part of a systemic infection.
  • Cauda Equina Syndrome: A medical emergency where the nerves in the spinal canal are compressed, leading to lower back pain, urinary retention or incontinence (which might be perceived as burning urination), and potentially a rash if there's associated infection or inflammation.
  • Sepsis: Especially if the patient has a UTI or another infection that has spread systemically, causing a rash (potentially a septic embolus causing a rash), back pain, and burning urination.

Rare Diagnoses

  • Reiter's Syndrome (Reactive Arthritis): A form of arthritis that occurs as a reaction to an infection elsewhere in the body, often in the gastrointestinal tract or the urinary tract. It can cause lower back pain, burning urination, and a rash, among other symptoms.
  • Sarcoidosis: A condition where inflammatory cells form lumps known as granulomas in various parts of the body, which can cause a wide range of symptoms including lower back pain, urinary symptoms, and skin rashes.

Related Questions

What are the preoperative recommendations for a Myasthenia Gravis patient on IVIG?
What are the recent guidelines for a weight loss program?
What are the guidelines for immediate treatment with IVIG (Intravenous Immunoglobulin)?
What is a good parameter to hold blood pressure medications, such as Angiotensin-Converting Enzyme (ACE) inhibitors or alpha blockers, in patients with hypotension?
Can herbal antimicrobial treatment be initiated for a patient with suspected Small Intestine Bacterial Overgrowth (SIBO) with methane dominance, in the absence of a breath test, following a severe Escherichia coli (E. coli) infection?
What labs should be ordered for a patient with gastrointestinal (GI) pain consistent with a possible gallbladder attack?

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question