Differential Diagnosis
The following conditions should be ruled out in the diagnosis of acute uncomplicated urinary tract infection:
- Asymptomatic bacteriuria corresponds to commensal colonization in the urinary system but without symptoms
- Urethritis is caused by Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus, Candida sp, or irritants (eg contraceptive gel). This is relatively more common if a woman has had a new sex partner or the sex partner has urethral symptoms and a past history of a sexually transmitted infection and symptoms (eg vaginal discharge, odor, and dysuria) were of gradual onset
- Vaginitis is suggested by the presence of vaginal discharge or foul odor, pruritus, dyspareunia, external dysuria, and no increased frequency or urgency
- Others such as interstitial cystitis, pelvic inflammatory disease (PID), structural urethral abnormalities, or obstructive pyelonephritis