A 59-year-old man comes to the emergency department because of fever, urinary frequency, and lower back pain for the last 3 days. During this period, he has also had pain with the 3 times he has defecated. He is sexually active with one female partner and does not use condoms. His father died of colon cancer at the age of 67 years. The patient has smoked one pack of cigarettes daily for 14 years and drinks alcohol occasionally. His temperature is 39.1°C (102.3°F), pulse is 114/min, and blood pressure is 140/90 mm Hg. Physical examination shows mild suprapubic pain on deep palpation and a swollen, tender prostate. The remainder of the examination shows no abnormalities. His hemoglobin concentration is 15.4 g/dL, leukocyte count is 18,400/mm3, and platelet count is 260,000/mm3. Which of the following pathogens is most likely responsible for this patient's current symptoms?

Question

Quizplus · Accepted Answer

Eductional Objective: Acute bacterial prostatitis is usually caused by reflux of urine and organisms from the bladder and urethra.  The risk is greater in patients with anatomic abnormalities (eg, strictures) or bladder catheterization.  Escherichia coli is the most common cause of acute bacterial prostatitis and other urinary tract infections because of adhesins on its fimbriae that promote adherence to urothelial or mucosal cells.

A 59-Year-Old Man Comes to the Emergency Department Because of Fever