Differential Diagnosis for Urinalysis Results

The urinalysis results showing 1+ leukocyte esterase, 5-10 WBC, and 11-20 squamous epithelial cells can indicate several conditions. Here's a breakdown of the differential diagnosis:

• Single Most Likely Diagnosis

  • Contamination: The presence of 11-20 squamous epithelial cells is a strong indicator of contamination, as these cells are typically found in the genital area and can be introduced into the urine sample during collection. The mild presence of leukocyte esterase and a moderate number of WBCs (5-10) could also be consistent with contamination, especially if the sample was not collected properly.

• Other Likely Diagnoses

  • Urinary Tract Infection (UTI): Although the WBC count is not extremely high, the presence of leukocyte esterase (an enzyme found in WBCs) suggests some level of infection or inflammation. UTIs can present with variable degrees of WBCs in the urine.
  • Asymptomatic Bacteriuria: This condition involves the presence of bacteria in the urine of asymptomatic individuals. It might not always lead to a significant increase in WBCs but could explain the leukocyte esterase positivity.

• Do Not Miss Diagnoses

  • Sexually Transmitted Infections (STIs): Certain STIs can cause urinary symptoms and the presence of WBCs in the urine. Although less likely, missing an STI could have significant health implications.
  • Kidney Stones or Obstruction: While the urinalysis results do not strongly suggest this, any condition causing urinary tract obstruction or irritation (like kidney stones) could potentially lead to an infection or inflammation, presenting with similar urinalysis findings.

• Rare Diagnoses

  • Tubulointerstitial Nephritis: An inflammation of the tubules and interstitial tissue of the kidneys, which could potentially present with mild urinary findings as seen in this case, although it is less common.
  • Malignancy: Very rarely, urinary tract malignancies could present with abnormal urinalysis findings, including the presence of WBCs and epithelial cells. However, this would be an uncommon initial presentation.