What are the differential diagnoses for hematuria with a negative urine culture and no bacterial presence?

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Last updated: April 26, 2025 • View editorial policy

Differential Diagnosis for Hematuria with Negative Urine Culture

Single Most Likely Diagnosis

  • Kidney Stones: The most common cause of hematuria without infection, kidney stones can cause bleeding in the urinary tract due to the stone's movement and irritation of the tract's lining.

Other Likely Diagnoses

  • Urinary Tract Injury: Trauma to the urinary tract, such as from a fall or car accident, can cause hematuria without infection.
  • Cancer of the Urinary Tract: Tumors in the kidneys, bladder, or ureters can bleed, leading to hematuria.
  • Glomerulonephritis: Inflammation of the glomeruli, the filtering units of the kidneys, can cause hematuria.
  • Prostate Issues: Enlargement or infection of the prostate gland can cause hematuria in men.

Do Not Miss Diagnoses

  • Sickle Cell Disease or Sickle Cell Trait: These conditions can cause hematuria due to sickling of red blood cells in the low-oxygen environment of the kidneys.
  • Alport Syndrome: A genetic disorder that affects the type IV collagen in the kidneys, leading to hematuria and potentially progressive kidney disease.
  • Vasculitis: Inflammation of the blood vessels, including those in the kidneys, can cause hematuria and is a potentially life-threatening condition if not treated promptly.
  • Renal Artery or Vein Thrombosis: Blood clots in the arteries or veins supplying the kidneys can cause hematuria and are medical emergencies.

Rare Diagnoses

  • Goodpasture Syndrome: A rare autoimmune disease that causes inflammation in the kidneys and lungs, leading to hematuria.
  • Loin Pain-Hematuria Syndrome: A rare condition characterized by recurrent episodes of severe flank pain and hematuria, often without an identifiable cause.
  • Nephrocalcinosis: A condition where there is an excessive accumulation of calcium in the kidneys, which can cause hematuria.
  • Tubulointerstitial Nephritis: Inflammation of the tubules and interstitial tissue of the kidneys, which can cause hematuria and is often associated with drug reactions or infections.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.