A 66-Year-Old Man Comes to the Emergency Department Due to a 3-Day

A 66-year-old man comes to the emergency department due to a 3-day history of fever, chills, dysuria, and perineal pain.  The patient has never had similar symptoms before, although he has had occasional nocturia and urinary hesitancy over the last 2 years.  His other medical conditions include type 2 diabetes mellitus and hypertension.  The patient does not use tobacco, alcohol, or illicit drugs.  He has not traveled recently and is not sexually active.  Temperature is 39 C (102.2 F) , blood pressure is 124/78 mm Hg, and pulse is 106/min.  The abdomen is soft and nontender with no costovertebral angle tenderness.  Digital rectal examination shows a smoothly enlarged and tender prostate.  External genitalia are normal with no scrotal tenderness.  There is no urethral discharge.  The remainder of the examination shows no abnormalities.  Urinalysis reveals bacteriuria and pyuria.  Which of the following pathogens is most likely responsible for this patient's current symptoms?

A) Chlamydia trachomatis
B) Coccidioides immitis
C) Escherichia coli
D) Mycoplasma hominis
E) Neisseria gonorrhoeae
F) Staphylococcus aureus
G) Staphylococcus saprophyticus
H) Ureaplasma urealyticum

Correct Answer:

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