Differential Diagnosis for Urinalysis Results
The urinalysis results provided indicate the presence of glucose, protein, nitrite, leukocyte esterase, WBCs, squamous epithelial cells, and bacteria in the urine. Based on these findings, the following differential diagnoses are considered:
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The presence of nitrite, leukocyte esterase, WBCs (11-20), and many bacteria in the urine strongly suggests a UTI. The trace amount of protein and glucose could be secondary to the infection.
Other Likely Diagnoses
- Diabetes Mellitus: The presence of glucose in the urine (100) could indicate diabetes mellitus, especially if the patient has other symptoms such as polyuria, polydipsia, or unexplained weight loss.
- Kidney Stones: Although not directly indicated by the urinalysis results, the presence of WBCs and bacteria could suggest a kidney stone causing a UTI.
- Pregnancy: The presence of glucose and protein in the urine could be seen in pregnancy, especially if the patient is experiencing gestational diabetes or preeclampsia.
Do Not Miss Diagnoses
- Sepsis: Although less likely, the presence of many bacteria and WBCs in the urine could indicate sepsis, especially if the patient has systemic symptoms such as fever, hypotension, or altered mental status.
- Pyelonephritis: The presence of WBCs, bacteria, and nitrite in the urine could suggest pyelonephritis, which is an infection of the kidney.
- Obstructive Uropathy: The presence of many bacteria and WBCs in the urine could indicate an obstructive uropathy, such as a kidney stone or tumor, causing a UTI.
Rare Diagnoses
- Tuberculosis: Although rare, the presence of WBCs and bacteria in the urine could suggest genitourinary tuberculosis.
- Malignancy: The presence of many bacteria and WBCs in the urine could indicate a malignancy, such as bladder or kidney cancer, although this would be rare and typically accompanied by other symptoms.