Acute prostatitis

Infobox Disease
Name = Acute Prostatitis
ICD10 = ICD10|N|41.0| |n|40
ICD9 = ICD9|601.0


Caption =
DiseasesDB = 10801
eMedicineSubj = med
eMedicineTopic = 2845
eMedicine_mult =
MedlinePlus = 000519
MeshName = Prostatitis
MeshNumber = D011472

Acute prostatitis is a serious bacterial infection of the prostate gland. This infection is a medical emergency. It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

igns and symptoms

Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract, as evidenced by white blood cells and bacteria in the urine. Acute prostatitis may be a complication of prostate biopsy.cite journal |author=Stoica G, Cariou G, Colau A, "et al" |title= [Epidemiology and treatment of acute prostatitis after prostatic biopsy] |language=French |journal=Prog. Urol. |volume=17 |issue=5 |pages=960–3 |year=2007 |pmid=17969797 |doi=]

Diagnosis

Acute prostatitis is relatively easy to diagnose due to its symptoms that suggest infection. The organism may be found in blood or urine, and some times in both. Common bacteria are "Escherichia coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Enterococcus, Serratia," and "Staphylococcus aureus." This can be a medical emergency in some patients and hospitalization with intravenous antibiotics may be required. A complete blood count reveals increased white blood cells. Sepsis from prostatitis is very rare, but may occur in immunocompromised patients; high fever and malaise generally prompt blood cultures, which are often positive in sepsis. A prostate massage should never be done in a patient with suspected acute prostatitis, since it may induce sepsis. Since bacteria causing the prostatitis is easily recoverable from the urine, prostate massage is not required to make the diagnosis. Rectal palpation usually reveals an enlarged, exquisitely tender, swollen prostate gland, which is firm, warm, and, occasionally, irregular to the touch. C-reactive protein is elevated in most cases.cite journal |author=Auzanneau C, Manunta A, Vincendeau S, Patard JJ, Guillé F, Lobel B |title= [Management of acute prostatitis, based on a series of 100 cases] |language=French |journal=Prog. Urol. |volume=15 |issue=1 |pages=40–4 |year=2005 |pmid=15822390 |doi=]

Treatment

Antibiotics are the first line of treatment in acute prostatitis (Cat. I). Antibiotics usually resolve acute prostatitis infections in a very short time. Appropriate antibiotics should be used, based on the microbe causing the infection. Some antibiotics have very poor penetration of the prostatic capsule, others, such as Ciprofloxacin, Co-trimoxazole and tetracyclines penetrate well. In acute prostatitis, penetration of the prostate is not as important as for category II because the intense inflammation disrupts the prostate-blood barrier. It is more important to choose a bacteriocidal antibiotic (kills bacteria, eg quinolone) rather than a bacteriostatic antibiotic (slows bacterial growth, eg. tetracycline) for acute potentially life threatening infections.cite journal |author=Hua VN, Schaeffer AJ |title=Acute and chronic prostatitis |journal=Med. Clin. North Am. |volume=88 |issue=2 |pages=483-94 |year=2004 |pmid=15049589 |doi=10.1016/S0025-7125(03)00169-X] Severely ill patients may need hospitalization, while nontoxic patients can be treated at home with bed rest, analgesics, stool softeners, and hydration. Patients in urinary retention are best managed with a suprapubic catheter or intermittent catheterization. Lack of clinical response to antibiotics should raise the suspicion of an abscess and prompt an imaging study such as a transrectal ultrasound (TRUS).cite journal |author=Göğüş C, Ozden E, Karaboğa R, Yağci C |title=The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess |journal=European journal of radiology |volume=52 |issue=1 |pages=94-8 |year=2004 |pmid=15380852 |doi=10.1016/S0720-048X(03)00231-6] E. coli is able to form a biofilm that may allow the pathogen to persist in the prostate.cite journal |author=Soto SM, Smithson A, Martinez JA, Horcajada JP, Mensa J, Vila J |title=Biofilm formation in uropathogenic Escherichia coli strains: relationship with prostatitis, urovirulence factors and antimicrobial resistance |journal=J. Urol. |volume=177 |issue=1 |pages=365–8 |year=2007 |pmid=17162092 |doi=10.1016/j.juro.2006.08.081] cite journal |author=Kanamaru S, Kurazono H, Terai A, "et al" |title=Increased biofilm formation in Escherichia coli isolated from acute prostatitis |journal=Int. J. Antimicrob. Agents |volume=28 Suppl 1 |issue= |pages=S21–5 |year=2006 |pmid=16828264 |doi=10.1016/j.ijantimicag.2006.05.006]

Prognosis

Full recovery without sequelae is usual.

References

External links

*Dmoz|Health/Men%27s_Health/Conditions_and_Diseases/Prostate/Prostatitis/|Prostatitis

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