Reference no: EM133365889

Assignment:

Case study: Patient with dysuria

Mr. Z is a 33-year-old man who complained of sudden onset of dysuria 5 days ago. He reports the pain radiates to his low back and perineum. He has felt "achy" and had chills but has not measured his temperature. He denies any penile discharge, rash, nausea, vomiting, or flank pain. He has had more difficulty urinating with a weaker urinary stream for the past few days. He also feels some dizziness upon standing. Mr. Z is sexually active with several female partners and does not use condoms or other barrier protection. He has no active medical problems but has noted nocturia over the past few months. Temperature is 38.2 °C, pulse 80 bpm, RR 12 breaths per minute, BP 142/78 mmHg, and orthostatic vital signs are negative. Abdominal exam demonstrates suprapubic tenderness without rebound or guarding and the absence of CVA tenderness. The genital exam is normal, but there is tenderness on the prostate exam without any palpable masses.

Mr. Z's urinalysis is positive for leukocyte esterase, 10 WBCs per high power field, ad 5 RBCs per high power field. His CBC shows a WBC count of 8000/mcL, and basic metabolic panel shows a creatinine of 1.0, similar to his previous baseline.

What are the differential diagnosis and corresponding labs?