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Seen in the ED: Urinary Frequency, Body Aches, Fever
The patient is a 52-year-old man and he has never had these symptoms before. Review lab results and CT findings. What's your diagnosis?
Patient history. A 52-year-old man presents to the emergency department complaining of fever, body aches, and urinary frequency. He denies any abdominal or flank pain, dysuria, unprotected sex, polydipsia, or other complaints and has never had these symptoms before.
Vital signs. Vital signs are normal except for temperature of 102°F.
Physical examination. Physical exam is otherwise normal with no abdominal or flank tenderness.
Initial diagnostic testing
Lab results:
- CBC, WBC = 8.9 but >70% PMNs
- Chem7 - normal
- Urinalysis, WBC >200/hpf, 1+ bacteria
Imaging: See CT scan image
What is the most likely diagnosis?
A. Cystitis
B. Pyelonephritis
C. Sexually transmitted infection (STI)
D. Prostatitis
Prostatitis from the Emergency Medicine 1-Minute Consult Pocketbook
Find many more puzzling presentations in our collection of Dr Pregerson's "Seen in the ED" cases.
Man With Newly Diagnosed Type 2 Diabetes: What HbA1c Goal-And How to Get There?
May 8th 2013The patient, an active 49-year-old man, had an HbA1c of 8.6 after diabetes was first diagnosed. It’s now 7.6 with metformin and lifestyle measures. Is the current A1c goal adequate, or should you treat more aggressively?
