Differential Diagnosis for 57-year-old Female Patient
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): The patient's symptoms of suprapubic pressure, urinary frequency, urgency, and dysuria are classic for a UTI. The absence of systemic symptoms like fever and back pain suggests a lower urinary tract infection.
Other Likely Diagnoses
- Interstitial Cystitis: This condition could explain the patient's symptoms of suprapubic pressure, frequency, and urgency, especially if the urine culture is negative for infection.
- Overactive Bladder: Symptoms of urinary frequency and urgency without infection could suggest overactive bladder.
- Gastroesophageal Reflux Disease (GERD) Flare: The patient reports a flare-up of her acid reflux, which is consistent with her symptoms of throat discomfort and her history of GERD.
Do Not Miss Diagnoses
- Pyelonephritis: Although the patient denies back pain and fever, it's crucial to consider pyelonephritis, an upper urinary tract infection that can lead to sepsis if not treated promptly.
- Kidney Stones: While the patient doesn't report severe pain, kidney stones could cause the symptoms she's experiencing, especially if they are small and not obstructing.
- Bladder Cancer: Although less likely, bladder cancer could present with similar symptoms, especially in an older adult.
Rare Diagnoses
- Diverticulitis: The patient's episode of diarrhea and suprapubic discomfort could, in rare cases, suggest diverticulitis, especially if the inflammation involves the bladder.
- Endometriosis: Although rare in postmenopausal women, endometriosis could cause suprapubic pressure and urinary symptoms if endometrial tissue is affecting the bladder.