Differential Diagnosis for UTI vs Stones vs Pyelonephritis
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common diagnosis, given the frequency of UTIs in the general population, especially in women. Symptoms such as dysuria, frequency, and urgency are classic for UTIs.
- Kidney Stones (Nephrolithiasis): This is also a likely diagnosis, especially if the patient presents with severe, colicky flank pain that radiates to the groin, which is typical for stones.
Other Likely Diagnoses
- Pyelonephritis: An infection of the kidney, which can present with symptoms similar to UTI but also includes flank pain, fever, and possibly nausea and vomiting. It's a likely diagnosis if the patient has signs of a systemic infection.
- Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can overlap with UTIs, but the absence of infection and the presence of chronic symptoms might suggest this diagnosis.
Do Not Miss Diagnoses
- Sepsis: Although less likely, sepsis is a potentially deadly condition that can arise from untreated or severe UTIs or pyelonephritis. Signs of sepsis include fever, tachycardia, tachypnea, and altered mental status.
- Obstructive Uropathy: A condition where the flow of urine is blocked, which can lead to severe consequences if not promptly addressed. This could be due to stones, tumors, or other causes.
- Emphysematous Pyelonephritis: A rare but serious infection of the kidney that produces gas in the tissue, more common in diabetic patients. It requires immediate medical attention.
Rare Diagnoses
- Tuberculosis of the Urinary Tract: A rare condition in many parts of the world, but it should be considered, especially in patients from endemic areas or with a history of TB. Symptoms can be similar to those of UTIs or pyelonephritis but are typically chronic.
- Malignancy (e.g., Bladder or Kidney Cancer): Although rare, these conditions can present with hematuria, weight loss, and other non-specific symptoms that might initially be attributed to UTIs or stones. A high index of suspicion is needed, especially in older patients or those with risk factors.