Dysuria Detailed history of physical exam Urinalysis Urine cultures Normal Genitourinary exam Urine Culture positive Urine Culture negative *Urinary Tract Infection Fever, other systemic symptoms Upper Urinary Tract Infection/Pyelonephritis Bacterial Candida Sexually Transmitted Infections* No fever, otherwise well Lower Urinary Tract Infection/Cystitis Bacterial Candida Sexually Transmitted Infections* Urine Culture negative Further urine studies warranted Viral infection Inflammatory (Eg. Kawasaki Disease*) Nephrolithiasis Abdominal Genitourinary exam Vesicles or Ulcers Sexually Transmitted Infections* Infectious (Eg. HSV, CMV) Systemic inflammatory illness (Eg. Steven-Johnson syndrome) Autoimmune conditions (Eg. Inflammatory bowel disease*, Becets disease) No vesicles or ulcers Vulvo-vaginitis* (Eg. Group A Streptococcus infection, candida infection, irritation) Balanitis* Phimosis* Labial adhesions Anatomic (Eg. Trauma, chemical irritation, foreign body) Dermatologic (Contact dermatitis, lichen planus, psoriasis, inflammatory skin conditions) *Indicates Key Condition This is not an exhaustive list of medical conditions.

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