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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.

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