Differential Diagnosis for 43 yo Male Patient with Flank Pain and Hematuria
- Single most likely diagnosis:
- Pyelonephritis: The patient's symptoms of flank pain and hematuria, along with the recent treatment with Rocephin (a broad-spectrum antibiotic), suggest a possible diagnosis of pyelonephritis. The absence of calculi or hydronephrosis on imaging studies and the normal renal ultrasound evaluation support this diagnosis.
- Other Likely diagnoses:
- Urinary Tract Infection (UTI): Given the patient's symptoms and the presence of blood in the urine, a UTI is a possible diagnosis. The normal ultrasound evaluation and the absence of calculi or hydronephrosis do not rule out a UTI.
- Interstitial Nephritis: This condition can cause flank pain and hematuria, and the patient's recent antibiotic treatment could be a potential cause.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Renal Cell Carcinoma: Given the patient's family history of kidney cancer, it is essential to consider the possibility of renal cell carcinoma, even though the ultrasound evaluation was normal.
- Ureteral Obstruction: Although the imaging studies did not show any evidence of obstruction, it is crucial to rule out ureteral obstruction, which can be life-threatening if not treated promptly.
- Vasculitis: Conditions like vasculitis can cause flank pain and hematuria, and if left untreated, can lead to severe complications.
- Rare diagnoses:
- Renal Infarction: This condition can cause flank pain and hematuria, but it is relatively rare and would require further evaluation, such as a CT scan or MRI, to diagnose.
- Renal Artery Aneurysm: Although rare, a renal artery aneurysm can cause flank pain and hematuria, and it is essential to consider this possibility, especially given the patient's family history of kidney disease.