A 65-year-old man presents to primary care center with a 5-day history of urinary dribbling, low back pain, peroneal pain, myalgias, and fevers with chills
A 65-year-old man presents to primary care center with a 5-day history of urinary dribbling, low back pain, peroneal pain, myalgias, and fevers with chills.
He reports one episode of urinary incontinence this week. He denies any hematuria. Patient has a history of a recent UTI. He also reports that his prostate has been enlarged.
Vital signs: Temp 103.0 F; HR 120, RR 26, BP 138/92, Pulse Ox 97% on RA
PSH: Transurethral resection (two months ago)
UA: Urinalysis with positive nitrites and trace bacteria.
Answer and Analysis these topics
- Explain why the likely diagnosis is prostatitis
- Explain the likely cause of prostatitis.
- Explain three causes of the systemic reaction
Expert Answer and Explanation
Prostatitis
Possible Diagnosis
Prostatitis is considered a possible diagnosis due to the following symptoms: The first symptom is difficulty urinating. The patient reports that he has a five-day history of urinary dribbling (Yebes et al., 2023). The second symptom is fever, chills, and myalgias. Prostatitis often causes muscle aches, fevers, and chills. The patient’s low back pain also indicates prostatitis. The disease causes abdominal pain, either in the lower back or groin.
In other words, all the symptoms reported by the patient can confirm that he has prostatitis (Yebes et al., 2023). A temperature of 103.0 F also confirms that he has a fever, which is a symptom of prostatitis. Prostatitis is also a likely diagnosis because the patient reported factors that increase his risk of developing the illness. They include a history of receptive urinary tract infection, transurethral resection two months ago, and an enlarged prostate (Yebes et al., 2023). Lastly, urine tests are positive for traces of bacteria, which can confirm that he has bacterial prostatitis.
Causes of Prostatitis
The disease’s causes vary depending on the type of illness. One of the causes is bacteria. Bacteria cause prostatitis, known as acute bacterial prostatitis. It often occurs when infections from other parts of the reproductive system spread to the prostates. Chronic bacterial prostatitis is the second type of disease (Yebes et al., 2023). Bacteria cause it but occurs when the treatment for acute bacterial prostatitis fails to eradicate the bacteria during the initial treatment.
The third type of prostatitis is chronic prostatitis, also known as chronic pain syndrome. It is caused by a variety of factors, including irregular hormone activity, immune system dysfunction, nervous system dysfunction, psychological stress, and previous infections (Yebes et al., 2023). The last type of prostatitis is asymptomatic inflammatory prostatitis. Its cause is not well understood. However, it is believed to occur when other medical problems affecting the reproductive system are not treated.
Systemic Reaction
A systemic reaction is a process that occurs when there is the spread of inflammation from a localized body part of a body organ, such as the skin, to other parts of the organ. This reaction differs from the localized one, which occurs only in a single place. One of the causes of systemic reactions is allergy, also known as anaphylaxis. Allergy causes a systemic reaction when inflammation moves from the skin and spreads to other organs, such as the lungs and blood (Greenhawt et al., 2021). The symptoms of systemic reactions caused by allergies include swelling of the lips, tongue, and face; itching; hives; shortness of breath; and fainting.
The second cause of a systemic reaction is an infection. A systemic reaction that occurs as a result of an infection is known as sepsis. Its symptoms include agitation, confusion, fatigue, light sensitivity, nausea, vomiting, low blood pressure, and feeling cold in the hands and feet or all over the body. The third cause of a systemic reaction is a toxin or poison. Some poisons and toxins can cause inflammation in the lungs and other organs of the body, leading to a systemic reaction (Greenhawt et al., 2021).
Some of the toxins that can cause systemic reactions include lead, mercury, carbon IV oxide, and many more poisonous chemicals. Symptoms of this reaction can vary but generally include confusion, fatigue, weakness, nausea, bright red skin, and headaches. Some poisons can also cause shortness of breath.
References
Greenhawt, M., Abrams, E. M., Shaker, M., Chu, D. K., Khan, D., Akin, C., Alqurashi, W., Arkwright, P., Baldwin, J. L., Ben-Shoshan, M., Bernstein, J., Bingemann, T., Blumchen, K., Byrne, A., Bognanni, A., Campbell, D., Campbell, R., Chagla, Z., Chan, E. S., Chan, J., … Golden, D. B. K. (2021). The Risk of Allergic Reaction to SARS-CoV-2 Vaccines and Recommended Evaluation and Management: A Systematic Review, Meta-Analysis, GRADE Assessment, and International Consensus Approach. The journal Of Allergy And Clinical Immunology. In practice, 9(10), 3546–3567. https://doi.org/10.1016/j.jaip.2021.06.006
Yebes, A., Toribio-Vazquez, C., Martinez-Perez, S., Quesada-Olarte, J. M., Rodriguez-Serrano, A., Álvarez-Maestro, M., & Martinez-Piñeiro, L. (2023). Prostatitis: a review. Current Urology Reports, 24(5), 241-251. https://link.springer.com/article/10.1007/s11934-023-01150-z
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