Differential Diagnosis
- Single most likely diagnosis
- Urinary Tract Infection (UTI) with atypical presentation: Although the urinalysis is negative, some UTIs, especially those caused by certain bacteria or in early stages, might not show positive results for leukocytes or nitrites. The symptoms of frequency, burning with urination, and mid/low back pain are classic for UTI.
- Other Likely diagnoses
- Interstitial Cystitis: This condition causes bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can mimic those of a UTI, but urinalysis is typically negative.
- Overactive Bladder: Characterized by a sudden urge to urinate, with or without urgency incontinence, usually with frequency and nocturia. It could explain the frequency and burning sensation.
- Prostatitis (in men): Inflammation of the prostate gland can cause urinary frequency, burning, and pelvic pain, with a negative urinalysis if not caused by a bacterial infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Kidney Stones: Although the primary symptom is usually severe pain, some patients might present with more subtle symptoms like frequency and burning. Missing a kidney stone could lead to severe complications if it causes an obstruction.
- Pyelonephritis: An infection of the kidney, which can present with back pain and urinary symptoms. A negative urinalysis does not rule out pyelonephritis, especially if the infection is early or localized.
- Tuberculosis of the Urinary Tract: A rare but serious condition that can cause chronic symptoms similar to UTI, including frequency and burning, with a negative routine urinalysis.
- Rare diagnoses
- Bladder Cancer: Could present with irritative voiding symptoms like frequency and burning, although this is less common. A negative urinalysis does not rule out bladder cancer.
- Schistosomiasis (in endemic areas): A parasitic infection that can cause urinary symptoms, including frequency and burning, due to the eggs of the parasite causing inflammation in the bladder wall.