Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of high-grade fever, chills, and malaise. Reports severe perineal/suprapubic pain, dysuria, frequency, urgency, and obstructive voiding symptoms. Denies recent instrumentation or trauma. No history of prior similar episodes.
Clinical Examination Findings
Vitals: Febrile (T > 38.5°C), tachycardic. Abdominal exam: Suprapubic tenderness, no rebound. Genitourinary: External genitalia normal. DRE: Prostate is exquisitely tender, warm, swollen, and indurated. Caution: Avoid vigorous prostatic massage due to risk of bacteremia.
Treatment Protocol
Initiate empiric IV/oral antibiotic therapy (Fluoroquinolones or TMP-SMX) pending culture results. Analgesics (NSAIDs), alpha-blockers for voiding symptoms, and adequate hydration. Monitor for signs of sepsis or urinary retention. Consider admission if patient is toxic or unable to tolerate oral intake.