Questions to consider asking the patient are: Are you having decreased force of stream, postvoid dribbling, or straining? Do you have a history of UTIs? Do you feel chills or fever? Does anything make your symptoms better or worse? Do you have any STDs or HIV? Differentials Acute Bacterial Prostatitis- risk factors for prostatitis include advanced age (older than 50 years), a history of a previously diagnosed UTI, and a history of prostatic calculi. Symptoms include frequency, urgency, dysuria, nocturia, fever and low back pain. Leukocytes are also present during a UA test. UTI- Symptoms include dysuria, urinary frequency or urgency, nocturia, hematuria, low back pain, and cloudy, foul-smelling urine. Positive nitrates in the urine are also an indication. BPH- Irritative symptoms of BPH include nocturia, urinary frequency, urgency, dysuria, and urge incontinence (Dunphy et al, 2019). If acute bacterial prostatitis is suspected then only a gently physical prostate exam should be done. Other testing includes a CBC to identify if there is any infection. Urine culture test should be done since there is a precent of infection in the dipstick results. Also, PSA blood test is important to determine if there is any sign of prostate cancer, a PSA level of 4 ng/mL or higher is indication of prostate cancer (ACA, 2021). The patient should be kept well hydrated as the color in his urine is dark yellow and specific gravity indicates dehydration. Close watch should be kept on urine retention and if urinary retention occurs, a suprapubic catherization may be needed. Note should be taken on the allergy to Bactrim and should be avoided. Fluoroquinolones such as levofloxacin (Levaquin) 750 mg by mouth daily for 5 days are commonly used for treating infection (Davis & Silberman, 2021). Next, referral to the urologist should be given. Please add 1 referenceShow more
