Differential Diagnosis for Urinalysis Positive for Leukocytes and Blood with Dysuria, Frequency, and Urgency
- Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is the most common cause of the symptoms described, including dysuria, frequency, urgency, and the presence of leukocytes and blood in the urine. The symptoms are classic for a lower urinary tract infection, such as cystitis.
- Other Likely Diagnoses
- Kidney Stones: The presence of blood in the urine (hematuria) along with pain (which could be inferred from dysuria) and possibly radiating pain could suggest kidney stones. However, the presence of leukocytes might suggest an associated infection.
- Interstitial Cystitis: This condition can cause chronic pain, frequency, and urgency, but it less commonly presents with leukocytes and blood in the urine. It's more of a diagnosis of exclusion.
- Do Not Miss Diagnoses
- Pyelonephritis: An upper urinary tract infection that can present with similar symptoms to a lower UTI but may also include flank pain, fever, and systemic symptoms. It's crucial to identify and treat promptly to prevent complications like sepsis or kidney damage.
- Tuberculosis of the Urinary Tract: Although rare, it can present with chronic symptoms of frequency, urgency, and hematuria. It's a critical diagnosis not to miss due to its implications for treatment and public health.
- Malignancy (e.g., Bladder or Kidney Cancer): While less common, these conditions can present with hematuria and, occasionally, symptoms of a UTI. Early detection is crucial for treatment outcomes.
- Rare Diagnoses
- Schistosomiasis: A parasitic infection that can cause urinary symptoms, including hematuria, and is more common in certain geographic areas.
- Sickle Cell Disease or Sickle Cell Trait: Can cause hematuria due to sickling in the low-oxygen environment of the kidney medulla.
- Goodpasture Syndrome: A rare autoimmune disease that can cause glomerulonephritis and pulmonary hemorrhage, presenting with hematuria among other symptoms.