A 40-year-old male with diabetes presents with dysuria, frequency, and fever. On examination, there are ulcers on the foreskin. What are the potential diagnoses, and what are the next steps?
This patient's presentation suggests a UTI, but the presence of foreskin ulcers also raises the possibility of a sexually transmitted infection, such as herpes simplex. Diabetic patients are also at risk of more severe infections. Urinalysis and culture should be performed to diagnose a UTI. In addition, swabs from the ulcers should be tested for herpes and other sexually transmitted infections. Empiric antibiotic treatment for the UTI should be started, and antiviral treatment for herpes should be considered based on the clinical picture.