Differential Diagnosis for Repeated Symptoms of UTI in Unmarried, Not Sexually Active Female with Normal Urine Reports and No Growth in Culture

• Single Most Likely Diagnosis
  • Overactive bladder or pelvic floor dysfunction: This condition can cause symptoms similar to UTI, such as frequent urination and urgency, without the presence of an infection.
• Other Likely Diagnoses
  • Interstitial cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can mimic UTI symptoms.
  • Urethral syndrome: Characterized by symptoms of UTI without evidence of infection, possibly due to urethral irritation or spasm.
  • Vulvodynia: Chronic pain or discomfort in the vulva, which can be mistaken for UTI symptoms.
• Do Not Miss Diagnoses
  • Tuberculosis of the urinary tract: Although rare, it can present with chronic or recurrent UTI-like symptoms without bacterial growth in standard cultures.
  • Urinary tract malformations or obstruction: Conditions like ureteropelvic junction obstruction or ectopic ureter can cause recurrent symptoms due to urinary stasis.
  • Cancer of the urinary tract: Though uncommon in young females, it's crucial not to miss this diagnosis, as it can present with nonspecific symptoms like recurrent UTI.
• Rare Diagnoses
  • Schistosomiasis: A parasitic infection that can involve the urinary tract, more common in certain geographic areas, and can cause symptoms similar to UTI.
  • Fungal infections of the urinary tract: Uncommon, especially in immunocompetent individuals, but can occur, particularly in those with specific risk factors like diabetes or prolonged use of antibiotics.
  • Spondyloarthritis or other autoimmune conditions: Certain autoimmune diseases can cause symptoms that mimic UTI, such as reactive arthritis or ankylosing spondylitis.