A Young Man With Dysuria

Abstract

A previously healthy 19-year-old man presented with a 2-month history of intermittent suprapubic pressure-like abdominal pain, dysuria, and 1-week history of pink discoloration of urine. His vital signs, WBC count, lactate level, and creatinine level were within normal limits. Physical examination revealed a soft abdomen with suprapubic tenderness. Urinalysis result was significant for cloudy, pink urine with >300 mg/dL proteinuria, >100 WBCs per high-power field, large red blood cells with >20 RBCs per high-power field, >1 bacteriuria, and positive for the presence of leukocyte esterase.For the diagnosis and teaching points, see page e30. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com