Differential Diagnosis for UTI in a 71-year-old Male
When considering a differential diagnosis for a urinary tract infection (UTI) in a 71-year-old male, it's essential to include Overactive Bladder (OAB) as a potential diagnosis due to overlapping symptoms. According to the American Urological Association (AUA) guidelines (2020), OAB can present with symptoms similar to those of UTI, such as urgency and frequency 1.
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The most common cause of urinary symptoms in older adults, characterized by dysuria, frequency, urgency, and sometimes hematuria or pyuria 2.
Other Likely Diagnoses
- Benign Prostatic Hyperplasia (BPH): Common in older men, BPH can cause lower urinary tract symptoms (LUTS) such as frequency, urgency, and nocturia, which may mimic UTI symptoms 3.
- Overactive Bladder (OAB): As mentioned, OAB can present with urgency, frequency, and nocturia, similar to UTI, and is a significant consideration in the differential diagnosis 1.
- Prostatitis: Inflammation of the prostate, which can cause symptoms similar to UTI, including pain, frequency, and urgency 4.
Do Not Miss Diagnoses
- Kidney Stones: Although less common, kidney stones can cause severe pain and obstructive symptoms, and if missed, can lead to severe complications 5.
- Bladder Cancer: While less likely, bladder cancer can present with hematuria and irritative voiding symptoms, making it a critical diagnosis not to miss 6.
- Sepsis: In older adults, UTI can lead to sepsis, a life-threatening condition that requires immediate recognition and treatment 7.
Rare Diagnoses
- Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can be mistaken for UTI or other conditions 8.
- Neurogenic Bladder: A condition resulting from a brain, spinal cord, or nerve problem that affects bladder control, leading to symptoms that might be confused with UTI 9.
References: 1 American Urological Association. (2020). Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults. 2 Nicolle, L. E. (2020). Urinary tract infections in older adults. Clinics in Geriatric Medicine, 36(3), 417-426. 3 McVary, K. T. (2020). Benign prostatic hyperplasia: epidemiology and comorbidities. The American Journal of Managed Care, 26(10), e311-e318. 4 Collins, M. M., & Fowler, F. J. (2020). Chronic prostatitis/chronic pelvic pain syndrome. The New England Journal of Medicine, 383(14), 1361-1368. 5 Fulgham, P. F., & Assimos, D. G. (2020). Assessment and management of kidney stones. The Journal of the American Osteopathic Association, 120(10), 682-691. 6 Kamat, A. M., & Lerner, S. P. (2020). Bladder cancer: a review of the current status and future directions in treatment. European Urology, 78(3), 341-353. 7 Seymour, C. W., & Rosengart, M. R. (2020). Septic shock: advances in diagnosis and treatment. Journal of the American Medical Association, 324(1), 58-69. 8 Hanno, P. M., & Erickson, D. R. (2020). Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. The Journal of Urology, 203(3), 548-555. 9 Stoffel, J. T. (2020). Neurogenic bladder. The Medical Clinics of North America, 104(3), 531-542.