Differential Diagnosis
- Single most likely diagnosis
- Bacterial vaginosis or urinary tract infection (UTI): The presence of pain with urination, white discharge, and a trace of leukocytes on the urine dipstick suggests a bacterial infection. The pH of 6 is within the normal range for urine, but the symptoms point towards a bacterial cause.
- Other Likely diagnoses
- Yeast infection (candidiasis): The white discharge could be indicative of a yeast infection, especially if it's thick and cottage cheese-like. However, the presence of pain with urination and leukocytes on the dipstick makes bacterial infection more likely.
- Trichomoniasis: This is a sexually transmitted infection that can cause vaginal discharge, pain with urination, and an abnormal urine dipstick test.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pelvic inflammatory disease (PID): Although less likely, PID is a serious condition that requires prompt treatment. It can cause pain with urination, abnormal discharge, and systemic symptoms like fever.
- Kidney stones: While the symptoms don't strongly suggest kidney stones, it's essential to consider this diagnosis, as it can cause severe pain and require urgent medical attention.
- Rare diagnoses
- Gonorrhea or chlamydia: These sexually transmitted infections can cause symptoms similar to those described, including pain with urination and abnormal discharge.
- Interstitial cystitis: A chronic condition that causes bladder pressure, pain with urination, and sometimes abnormal urine test results. However, it's less likely given the acute presentation and presence of white discharge.