Differential Diagnosis
- Single most likely diagnosis
- Acute pyelonephritis or urinary tract infection (UTI): The presence of a renal calculus, elevated WBC count (12.3), trace blood in urinalysis, and bacteria in the urine suggest an infection. The CRP of 4.4 also indicates an inflammatory process, which is consistent with a UTI or pyelonephritis.
- Other Likely diagnoses
- Ureteritis or cystitis: These conditions could also present with similar symptoms and lab results, especially if the infection is not limited to the kidney.
- Renal colic: Although the renal calculus is non-obstructing, it could still cause pain and potentially lead to an infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: An elevated WBC count and CRP could indicate a more severe infection, potentially leading to sepsis, which is life-threatening if not promptly treated.
- Xanthogranulomatous pyelonephritis: A rare but serious condition that can occur in the presence of a long-standing infection and renal calculus, potentially leading to severe kidney damage.
- Emphysematous pyelonephritis: A rare and severe infection of the kidney, which can be life-threatening if not promptly treated.
- Rare diagnoses
- Tuberculosis of the kidney: Although less common, TB can infect the kidney and present with similar symptoms, including hematuria and infection.
- Renal cell carcinoma: A tumor could potentially cause hematuria and an elevated WBC count, although this would be less likely given the presence of a renal calculus and infection.