Differential Diagnosis for Urinalysis Results
The urinalysis results showing leucocytes of 117 and erythrocytes of 1392 with moderate mixed growth on culture suggest a urinary tract infection (UTI) or other conditions affecting the urinary system. Here's a categorized differential diagnosis:
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of leucocytes and erythrocytes in the urine, along with a moderate mixed growth on culture, strongly suggests a UTI. The mixed growth could indicate a complicated UTI or contamination, but the clinical context and symptoms would guide the diagnosis.
Other Likely Diagnoses
- Kidney Stones: The significant number of erythrocytes (1392) could indicate a condition like kidney stones, which can cause hematuria (blood in the urine) and potentially lead to a UTI.
- Interstitial Cystitis: Although less common, interstitial cystitis could present with hematuria and symptoms of a UTI without a significant bacterial infection, though the mixed growth on culture makes this less likely.
- Prostatitis: In males, prostatitis could cause similar symptoms and urinalysis results, especially if the prostate is involved.
Do Not Miss Diagnoses
- Pyelonephritis: An infection of the kidney, which can present with similar urinalysis results and requires prompt treatment to prevent serious complications.
- Sepsis: Although less likely, if the patient shows signs of systemic infection (fever, hypotension, etc.), sepsis should be considered, especially in vulnerable populations.
- Tuberculosis of the Urinary Tract: Though rare, it can cause chronic infection and hematuria, and a mixed growth on culture might not capture the causative organism.
Rare Diagnoses
- Malignancy: Certain cancers, like bladder or kidney cancer, can cause hematuria. However, they would be less likely to present with a mixed bacterial growth on urine culture.
- Goodpasture Syndrome: A rare autoimmune disease that can cause glomerulonephritis and pulmonary hemorrhage, presenting with hematuria.
- Alport Syndrome: A genetic disorder affecting the type IV collagen in the kidneys, ears, and eyes, which can cause hematuria but would not typically present with a UTI-like picture on urinalysis.