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Old 08-08-2011
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Default Pain on urination

A 62-year-old man presents to the emergency department with complaints of fever, chills, nausea, and pain on urination. On admission he appears to be dehydrated. He has not been eating or drinking for the past few days because he fears urination.
He has been having progressively worsening pain during urination and rectal pain on defecation for the past week. He denies urinary hesitance or incontinence. He has a low-grade fever that started two days before admission. On examination, the patient is noted to have suprapubic tenderness. Rectal examination reveals severe tenderness with a diffusely enlarged and boggy prostate. The stool is brown and negative for occult blood. He has a temperature of 101.9 F. The urinalysis shows 2+ blood, 1+ protein, 3+ white cells, and is positive for nitrites. His white blood cell count is 18,000/mm3. What is most appropriate for this patient?

(A) Ampicillin and gentamicin
(B) Cystoscopy
(C) Gentle prostate massage
(D) Increase fluid intake and administer one week of oral trimethoprim/sulfamethoxazole
(E) Prostrate-specific antigen (PSA) level
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chakdeindia (08-08-2011)

Old 08-08-2011
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Its prostatitis...So AMP and GENT
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Old 08-08-2011
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I agree ,,
Ampicillin and gentamycin
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chakdeindia (08-08-2011)


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