A 45-year-old man comes to the office because of pain during
urination, in addition to increased urinary frequency and chills. The symptoms have been present since yesterday. He denies any pelvic pain, myalgias or malaise. He has not been sexually active since his spouse died 2 years ago. Past medical history is significant for
diabetes mellitus and
hypertension for 20 years.
Current medications include
metformin and
amlodipine. Family history is significant for
bladder cancer in his deceased father. Temperature is 38.5°C (101.4°F),
pulse is 100/minute, and
blood pressure is 130/70 mmHg. Digital rectal examination reveals a warm, tender, and boggy
prostate. Complete blood profile shows hemoglobin 11 g/L and leukocytes 14,000/mm3.
Urinalysis is as follows:
| Laboratory value | Result |
| Urinalysis |
| Specific gravity | 1.013 |
| Glucose | Negative |
| Blood | Negative |
| Leukocyte esterase | Positive |
| Nitrites | Positive |
| Leukocytes | 10-12/hpf |
| Erythrocytes | 1-2/hpf |
What of the following is the most likely etiology of this patient’s condition?
