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: November 1, 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 Agricultural Worker with Low Back Pain and Urinary Symptoms

  • Single most likely diagnosis:
    • Pyelonephritis or Urinary Tract Infection (UTI): The patient's symptoms of burning micturition, low back pain, and the presence of a mild elevation in creatinine suggest a possible infection of the urinary tract. The fact that the patient is a smoker could also contribute to an increased risk of urinary tract issues.
  • Other Likely diagnoses:
    • Musculoskeletal strain: Given the patient's occupation as an agricultural worker, it's plausible that the low back pain could be related to physical strain or injury.
    • Pneumonia or lower respiratory tract infection: Although the lungs are clear, the presence of mild chest pain, cough with sputum, and being a smoker could suggest an early or mild respiratory infection.
    • Nephrolithiasis (Kidney Stones): The low back pain and burning micturition could also be indicative of kidney stones, especially if the pain is severe and colicky in nature.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
    • Pulmonary Embolism (PE): Despite the lungs being clear and the ECG being normal, a pulmonary embolism could present with mild chest pain and cough. It's crucial to consider this diagnosis due to its high mortality rate if missed.
    • Acute Coronary Syndrome (ACS): Although the ECG is normal, cardiac issues can sometimes present atypically, especially in smokers. The mild chest pain warrants consideration of cardiac causes.
    • Sepsis: If the patient's condition is due to an infection (like pyelonephritis), there's a risk of sepsis, especially if not promptly treated.
  • Rare diagnoses:
    • Tuberculosis: Given the patient's occupation and symptoms, although less likely, tuberculosis could be a consideration, especially if the patient has been exposed or has risk factors for TB.
    • Spinal or renal tumors: These could cause low back pain and urinary symptoms but are less common and would typically require further diagnostic testing to confirm.

Related Questions

What is the treatment for orbital cellulitis?
Is Ryzodeg (insulin degludec and insulin aspart) administered once daily?
What adjustments should be made in a patient who develops acute pancreatitis secondary to the use of asparaginase (L-asparaginase)?
What treatment should be given for a patient with suspected urinary tract infection, pyelonephritis, and mild respiratory symptoms?

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