A Man with Urinary Tract Infection

Author: V. Dimov, M.D.
Reviewer: S. Randhawa, M.D.

A 49-year-old African American male (AAM) presented to the ER with a chief complaint of increased urinary frequency for 4 days. He was seen in the ER 3 days ago, diagnosed with urinary tract infection (UTI), and Bactrim was prescribed. Urinary frequency decreased but his urine turned dark and he developed fever and chills.

What are the causes of UTI in men?

UTI in men is rare. Risk factors include:

- homosexuality
- intercourse with an infected female partner
- current or recent urinary catheter

Prostatis should always be ruled out by a rectal examination since the duration of antibiotic treatment is much longer in prostatitis (4 weeks) than in UTI. Patients with pyelonephritis should be treated with antibiotics for 2 weeks.

What imaging studies should be ordered in men with UTI?

Renal ultrasound or CT scan with IV contrast should be ordered to rule out urinary tract pathology.

References:

Acute cystitis and asymptomatic bacteriuria in men. UpToDate 14.1 (subscription required)
Indications for radiologic evaluation in acute pyelonephritis. UpToDate 14.1 (subscription required)
Urinary Tract Infection - JAMA Patient Page (PDF) http://goo.gl/Zf4Zv

Published: 08/18/2006
Updated: 04/12/2012

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