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Q. My brother has a fever, and his PSA is 25. How to reduce infection?

Answered by
Dr. Samer S J Altawil
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 03, 2021

Hi doctor,

My brother is 69 years old. Having HT and DM. He is presently taking the following medicines:

1) Amlong-H for BP.

2) Zita-met plus 20 or 500 mg for sugar.

3) Amaryl M2 for sugar.

4) Flodart plus for urine.

5) Orcerin GM for knee pain.

Since the last two days, he has a fever and started the following medicines:

1) Crocin 650.

2) Naprosyn 500.

3) Urispas.

4) Faronem Er 300 mg.

5) Fourts B vitamin tablet.

6) Aciloc 150 mg.

First, we have done his COVID Test, and it is negative since he has already taken both vaccines.

1) Rapid Antigen is negative.

2) HRCT is normal.

3) His Blood Test says CRP-146 and WBC-17900.

4) Urine normal with micro organism positive.

5) Today, his PSA has come to 25.

His urine culture report is pending. What medicines should be added to reduce the infection? What further investigation are required? I have attached the reports for your reference. Please give your suggestion.

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#

Hi,

Welcome to icliniq.com.

The cause for fever is an infection, and as also the CRP (C-reactive protein) is elevated. CT (computed tomography) scan of the thorax is normal (attachments removed to protect the patient's identity). The urine analysis so far is fine. But should wait for the urine culture test result. Possible causes can be abdominal or pelvic. Therefore ultrasound of the abdomen and pelvis is required. Other causes can be prostate, urine, or heart valves.

Inflammation of the prostate can be known on examination, feeling the prostate whether it is painful or not. To be noted, elevated PSA (prostate-specific antigen) can be due to this inflammation and will go down on treatment. Heart valves will need an ultrasound as well as echocardiography. If PSA remains high after ruling out prostatitis, you will need MRI (magnetic resonance imaging) for the prostate to know whether you need a biopsy or not.

I suggest starting tablet Ciprofloxacin 500 mg twice daily for two weeks.

Please update me about the condition and follow up with culture results to continue with management. If you have any more queries, please do not hesitate to ask.

Hi doctor,

Thank you.

All investigations should be done or can do one by one, like echocardiography and abdomen whole ultrasound?

Because due to the high pick of COVID, it is difficult to move forward. Is it possible to take antibiotics for two weeks then go for echocardiography and ultrasound of the abdomen? Are you a urologist? Please guide me.

#

Hi,

Welcome to back icliniq.com.

Yes, I am a urologist. Sure he can start the antibiotic first, then go for the tests and repeat PSA after four weeks. I hope this was helpful.


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