Causes of Dysuria - Differential Diagnosis Algorithm

Pyuria - Leukocytes on Dipstick/Microscopy

 - Bacteriuria & Hematuria - Dipstick positive for nitrites (if infected with enterobacteria).

      • Upper Urinary Tract Infection/Pyelonephritis - WBC Casts

       • Lower Urinary Tract Infection/Cystitis - WBC Clumps

 - No Bacteriuria & No Hematuria - Dipstick negative for nitrites.

      • Gonococcal

      • Non-Gonococcal (e.g. Chlamydia, Trichomonas)

No Pyuria - No Leukocytes on Dipstick/Microscopy

 - Urethritis

     • Candida

     • Herpes Simplex Virus

 - Vaginitis

     • Candida

     • Gardnerella

     • Neoplasm

 - Non-Pathogenic

     • Estrogen deficiency

     • Interstitial cystitis

     • Radiation cystitis



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