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Case Report: Acute Urinary Retention and Fever in a Man

By Matthew Turner, MD; and Catherine Marco, MD, FACEP | on January 12, 2024 | 0 Comment
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Ultimately, in elderly patients presenting with AUR and fever of an unclear etiology, rapid decompression of the bladder through catheterization should be achieved.10 Afterward, the patient’s medication list—including the use of over-the-counter medications such as NSAIDs—should be carefully reviewed for signs of any causative agents.2,10

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ACEP Now: Vol 43 – No 01 – January 2024

In the case described, a postvoid residual ultrasound showed that the patient was retaining approximately 700 mL of urine. His bladder was successfully drained with the placement of a urethral catheter, and a UA showed him to have significant bacteriuria. Due to the possibility of acute prostatitis, a digital rectal exam was deferred. Ultrasound imaging showed evidence of a heterogeneous, inflamed prostate, and the patient was diagnosed with acute prostatitis. While the urine culture was pending, the patient was empirically started on a broad-spectrum intravenous antibiotic and admitted to the hospital, where he rapidly improved. 48 hours later, the patient’s urine culture grew E. coli colonies, sensitive to trimethoprim/sulfamethoxazole. The patient was discharged on a four-week course of oral antibiotics, and followed up in clinic for repeat urine cultures. Ultimately, the patient made a full recovery.


Dr. Turner is an emergency medicine intern at Hershey Medical Center in Hershey, PA.

Dr. Marco is professor of emergency medicine at Penn State Health-Milton S. Hershey Medical Center and associate editor of ACEP Now.

References

  1. Oelke M, Speakman MJ, Desgrandchamps F, et al. Acute urinary retention rates in the general male population and in adult men with lower urinary tract symptoms participating in pharmacotherapy trials: A literature review. Urology. 2015;86(4):654-65.
  2. Verhamme KM, Sturkenboom MC, Stricker BH, et al. Drug-induced urinary retention: incidence, management and prevention. Drug Safety. 2008;31:373-88.
  3. Curtis LA, Dolan TS, Cespedes RD. Acute urinary retention and urinary incontinence. Emerg Med Clin North Am. 2001;19(3):591-620.
  4. Lee SY, Kang SB, Kim DW, et al. Risk factors and preventive measures for acute urinary retention after rectal cancer surgery. World J Surg. 2015;39:275-82.
  5. Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. 2008;77(5):643-50.
  6. Coyle EA, Prince RA. Urinary tract infections and prostatitis. In: Linn WD, Wofford MR, O’Keefe ME, et al., eds. Pharmacotherapy in Primary Care. New York, NY: McGraw Medical; 2009:475-81.
  7. Gill BC, Shoskes DA. Bacterial prostatitis. Current Opinion in Infectious Diseases. 2016;29(1):86-91.
  8. Basoulis D, Mylona M, Toskas P, et al. Meningitis-retention syndrome. Int Neurourol J. 2015;19(3):207-9.
  9. Pellegrino F, Funiciello E, Pruccoli G, et al. Meningitis-retention syndrome: a review and update of an unrecognized clinical condition. Neurol Sci. 2023;44(6):1949-57.
  10. Thorne MB, Geraci SA. Acute urinary retention in elderly men. Am J Med. 2009;122(9):815-9.

Pages: 1 2 3 4 | Single Page

Topics: acute urinary retentionCase ReportsDrug InteractionsInfectious DiseasesMeningitismeningitis retention syndromeprostatitis

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