Recurrent Urinary Tract Infections in a Young Adult Male

Case at a Glance

A 26-year-old male presents with recurrent urinary tract infections occurring 1.5 months apart, which is unusual for his demographic. Despite maintaining good hygiene and having no sexual activity, he experienced two episodes of UTI with similar symptoms.

Patient's Story

The patient is a 26-year-old unmarried male who experienced his first urinary tract infection and received appropriate treatment. However, approximately 6 weeks later, he developed similar symptoms suggesting a recurrent UTI. He maintains a healthy lifestyle as a vegetarian who occasionally consumes eggs, abstains from smoking, alcohol, and carbonated beverages. He reports no sexual activity and maintains good personal hygiene practices. His water intake varies from adequate to potentially insufficient (1-1.5L daily) during travel periods. He occasionally consumes outside food 2-3 times monthly.

Initial Assessment

The patient presented with typical UTI symptoms on two separate occasions. Initial workup revealed no evidence of kidney stones on contrast CT imaging. Recent laboratory results showed vitamin D deficiency with levels at 12.8 ng/mL (normal >30 ng/mL). The patient expressed concerns about potential contributing factors including nocturnal emissions and hygiene practices.

The Diagnostic Journey

Given the unusual presentation of recurrent UTIs in a young male without sexual activity, comprehensive evaluation was warranted. Urine cultures were obtained during both episodes to confirm bacterial etiology and guide antibiotic therapy. The patient underwent contrast-enhanced CT imaging to rule out structural abnormalities, which was negative for nephrolithiasis or other urological pathology.

Final Diagnosis

Recurrent urinary tract infection in a young adult male with vitamin D deficiency. The etiology remains unclear given the absence of typical risk factors such as sexual activity, structural abnormalities, or immunocompromising conditions.

Treatment Plan

1. Antibiotic therapy based on urine culture and sensitivity results for current infection. 2. Vitamin D supplementation to address deficiency. 3. Referral to urology for further evaluation given the unusual presentation of recurrent UTIs in a young male within 6 months, as per clinical guidelines. 4. Counseling on optimal hydration practices (minimum 2-3L daily). 5. Review of hygiene practices and lifestyle modifications.

Outcome and Follow-up

The patient responded well to antibiotic treatment for both episodes. Urological evaluation is pending to investigate potential underlying causes such as functional or anatomical abnormalities that may predispose to recurrent infections. Long-term follow-up will focus on prevention strategies and monitoring for additional recurrences. Patient education provided regarding the importance of adequate hydration and prompt medical attention for any urinary symptoms.