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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5086
Experience:  Emergency Medicine Physician
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Complicated UTI - Prostatitis please help.

Resolved Question:

Around 3 months ago I developed symptoms of UTI, I was tested positive for nitrates and proteins.

I was put on a course of Nitrofurantoin which worked, but I did not finish the course, the symptoms returned and the remaining pills did not clear the infection. I was prescribed Trimethoprim, then told by a another GP I did not have a UTI as the culture came back negative. so i stopped the Trimethoprim.

I was referred to a urologist who claimed I have OAB. I was given a course of Vesicare 5mg, this medicine did not work, I was in agony one evening so I went to A&E (May be called ER in the US) I was told again I did have an infection and was given Doxycycline for 1 week. I took this and it worked. Unfortunately the dose didn't seem to be long enough, symptoms returned, I booked in to see a urologist who prescribed me Ciprofloxacin.

This worked again, but took around 2-3 weeks, at around the 2 week mark i missed 3 doses as the shape of the tablets had changed and I took the wrong ones from my pill minder. I started taking them again but my symptoms have returned worse than ever. I am not worried that I've exhausted all antibiotics and have created an anti-bacterial resistant UTI.

I am in absolute agony, my testicles are in so much pain, my back hurts I have the constant urge to urinate (I can't) I feel reallly ill and I haven't eaten in 3 days.

Long story short.

Taken 4 types of antibiotics for UTI.
UTI not cleared, antibiotics stopped working.
In incredible pain, and discomfort.

Not testing positive for UTI any more.

Heart rate is ~100-120
BP 140/110
Internal Temperature 37.3°c - 37.8°c - taken rectally with digital thermometer. Now 37.3°c
Weight - 160lbs
Height 5' 10"

If I go to the hospital they won't do anything, please advise.
Submitted: 1 year ago.
Category: Medical
Expert:  911DOC replied 1 year ago.

I see you titled your post 'prostatitis', and i think this is the likely diagnosis.

 

In men under 35 this is usually an STD and requires different antibiotics than men who have prostatitis from an enlarged prostate.

 

The typical treatment for men under 35 years old is Rocephin (ceftriaxone) as an injection and doxycycline, or TWO weeks of Septra (trimethoprim sulfamethoxazole).

 

Alternatively, IV antibiotics (ampicillin and gentamycin) are given a few times a day for two weeks which requires an in home nurse visit and a temporary indwelling IV line.

 

However, you now seem to be in the 'chronic' category of prostatitis, which, as you have guessed, takes a much longer course of antibiotics.... up to twelve weeks, usually Septra.

 

Also, since you now have testicular pain, the fact is that you need an ultrasound of the testicles to rule out Epididimo-orchitis, an infection of the testicles and epididymus.

 

HERE IS A LINK ON PROSTATITIS

HERE IS A LINK ON EPIDIDIMO-ORCHITIS

 

In short, you are right to be concerned. The diagnosis was missed initially and I do not think the first few providers who saw you did their due diligence. I would not hesitate to go back to A and E and tell them that you think you have prostatitis and epididimo-orchitis and believe you need treatment for this, and an ultrasound of the testicles. This sounds like it is getting out of control and this can, as you guess, be dangerous. Do not hesitate, print out the linked articles and DEMAND proper treatment now, as every day that your pain increases raises the risk of failure of treatment of spread of infection.

 

I am standing by if you have questions for me.

 

Best

911Doc

911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5086
Experience: Emergency Medicine Physician
911DOC and 4 other Medical Specialists are ready to help you

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