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  #1  
Old 06-08-2012
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Question elderly man with recurrent UTI....most apropriate test?

A 62-year-old man presents to your clinic complaining of four days of dysuria, frequency, and urgency. He feels slightly feverish and has had dull, lower-back pain for the past few months. He has had several episodes of the dysuria over the last several months. Each time he was given antibiotics for one week, and the symptoms resolved. Currently his temperature is 100.4 F. The genital examination is unremarkable, and the digital rectal examination reveals a nontender prostate, which is normal in size and consistency, with no palpable masses. After gentle massage of the prostate, a small amount of purulent discharge is extruded from the urethral meatus. The urine culture grows 100,000 colonies/mL of E. coli. Urine cultures from his prior symptomatic episodes also grew E. coli but only 10,000 colonies/mL. Which of the following is most appropriate?
(A) Cystoscopy
(B) Ciprofloxacin and azithromycin orally once now
(C) Trimethoprim/sulfamethoxazole for one week
(D) Renal ultrasound
(E) Ciprofloxacin for 4 to 6 weeks
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Old 06-09-2012
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E seems like chronic prostatitis
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Old 06-09-2012
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(E) Ciprofloxacin for 4 to 6 weeks

Chronic bacterial prostatitis
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Old 06-09-2012
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Quote:
Originally Posted by tyagee View Post
A 62-year-old man presents to your clinic complaining of four days of dysuria, frequency, and urgency. He feels slightly feverish and has had dull, lower-back pain for the past few months. He has had several episodes of the dysuria over the last several months. Each time he was given antibiotics for one week, and the symptoms resolved. Currently his temperature is 100.4 F. The genital examination is unremarkable, and the digital rectal examination reveals a nontender prostate, which is normal in size and consistency, with no palpable masses. After gentle massage of the prostate, a small amount of purulent discharge is extruded from the urethral meatus. The urine culture grows 100,000 colonies/mL of E. coli. Urine cultures from his prior symptomatic episodes also grew E. coli but only 10,000 colonies/mL. Which of the following is most appropriate?
(A) Cystoscopy
(B) Ciprofloxacin and azithromycin orally once now
(C) Trimethoprim/sulfamethoxazole for one week
(D) Renal ultrasound
(E) Ciprofloxacin for 4 to 6 weeks
ans is indeed E and diagnosis is chronic prostatitis.

there is no prostate tenderness in this !!! i know but keep forgetting ;-(

isnt duration for chronic and acute prostatitis the same-- 4 to 6 weeks
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