S2D: The Symptom to Diagnosis Podcast Dysuria
May 26, 2021
Dive into the discomfort of dysuria with a case study of a 67-year-old man. Explore the diagnostic maze, distinguishing between cystitis and prostatitis. Discover the key signs that indicate pyelonephritis and the importance of pelvic exams for women. Uncover the link between penile discharge and STIs. Learn how atypical presentations in the elderly can mislead diagnoses and why thorough histories are essential. Finally, understand the crucial aspects of managing urosepsis and the conditions that necessitate urine cultures.
AI Snips
Chapters
Books
Transcript
Episode notes
Older Man With Prostatitis Presentation
- A 67-year-old man had four days of dysuria, increased frequency, and felt warm at night.
- He had an exquisitely tender prostate and improved after a long course of antibiotics for prostatitis.
Don't Check PSA During Acute Prostatitis
- Do not check PSA during acute prostatitis because inflammation raises PSA and confounds cancer screening.
- Repeat PSA in 1–2 months after recovery if needed.
Positive Leukocyte Esterase Is Strong Evidence
- A positive leukocyte esterase greatly increases the likelihood of cystitis.
- A positive result has a likelihood ratio roughly between 12 and 48.
