Case history
Case history #1
A 59-year-old man describes urinary frequency, urgency, and dysuria for several days. He denies the presence of haematuria or penile discharge, but does have 3 episodes of nocturia most nights. His past medical history includes benign prostatic hyperplasia (BPH). The patient is in a monogamous relationship with his wife.
Case history #2
A 70-year-old man, who has been an inpatient for 4 days with an exacerbation of congestive heart failure, is now complaining of unilateral back pain. He has had an indwelling urinary catheter to strictly monitor urine output since admission. He also relates a history of increasing suprapubic discomfort for the last 24 hours. Examination confirms fever, suprapubic tenderness, and costovertebral angle tenderness.
Other presentations
Symptoms specifically related to urinary tract infection (UTI) include dysuria, frequency, urgency, suprapubic pain, or costovertebral angle pain. In men, however, fever and urethral discharge may also occur.[5][6] Some patients may have symptoms related to BPH or urethral stricture, such as hesitancy, incomplete emptying, or nocturia. In addition, there may be symptoms of prostatitis, such as rectal or perineal pain. Older patients may present with altered mental status secondary to UTI. However, with the high prevalence of asymptomatic bacteriuria in this group, it is important to search for other causes of altered mental status despite the presence of abnormal urine testing or culture.
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