What is the likely etiology of low back pain in a 75-year-old male with a history of Transurethral Resection of the Prostate (TURP) six weeks prior, presenting with low-grade fever and lumbar spine tenderness?

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Differential Diagnosis for 75 year-old male with low back pain

  • Single most likely diagnosis
    • Prostate abscess or prostatitis: Given the recent history of Transurethral Resection of the Prostate (TURP) six weeks prior, the patient is at risk for developing a prostate abscess or prostatitis, which can cause low back pain, low-grade fever, and tenderness.
  • Other Likely diagnoses
    • Urinary Tract Infection (UTI): A UTI can occur after a TURP procedure and cause symptoms such as low back pain, fever, and tenderness.
    • Discitis or osteomyelitis: Infection of the intervertebral disc or vertebral body can cause low back pain, fever, and tenderness, especially in the context of a recent surgical procedure.
    • Epididymitis: Inflammation of the epididymis can cause low back pain, fever, and tenderness, particularly if it is related to a UTI or prostatitis.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Spinal epidural abscess: Although less common, a spinal epidural abscess is a serious and potentially life-threatening condition that requires prompt diagnosis and treatment.
    • Sepsis: Any infection, including those related to the urinary tract or prostate, can lead to sepsis, a life-threatening condition that requires immediate attention.
    • Cauda equina syndrome: A rare but serious condition that can occur due to compression or infection of the spinal nerves, requiring urgent medical attention.
  • Rare diagnoses
    • Psoas abscess: An abscess in the psoas muscle can cause low back pain, fever, and tenderness, although it is a less common condition.
    • Tuberculosis of the spine: Also known as Pott's disease, this is a rare condition that can cause low back pain, fever, and tenderness, particularly in immunocompromised individuals.
    • Metastatic cancer: Although less likely, metastatic cancer to the spine can cause low back pain, and a diagnosis of cancer would significantly impact treatment and management.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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