• Acute (bacterial) prostatitis:
    • Acute febrile illness
    • Systemic symptoms may appear days before localizing urinary symptoms appear
    • Patients may appear toxic and usually have a concurrent cystitis
  • Chronic bacterial prostatitis:
    • ∼10% of cases of prostatitis
    • Most common cause of recurrent UTI in men
    • WBC and bacteria may be present in expressed prostatic secretions (EPS)
  • Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS):
    • Same symptoms as chronic bacterial prostatitis but unable to culture organisms from urine or EPS
    • White cells may or may not be present
  • Asymptomatic inflammatory prostatitis:
    • No subjective symptoms on presentation
    • Inflammation present on prostate biopsy or evaluation for infertility or other disorders
  • Prostatic abscess:
    • Once common after acute prostatitis, now rare except in immunocompromised patients
    • Fever, rectal pain, and leukocytosis despite treatment
    • Fluctuant mass on rectal exam


  • Usually a single-organism bacterial infection of the prostate
  • Acute prostatitis:
    • Age <35 yr:
      • Neisseria gonorrhoeae and Chlamydia trachomatis are usual etiologies
    • Age ≥35 yr:
      • Enterobacteriaceae or Escherichia coli (usual), Klebsiella, Pseudomonas, Enterococcus, and Proteus also seen
    • Rarely may be caused by Salmonella, Clostridia, tuberculosis, or fungi
    • Cryptococcus neoformans in AIDS patients
  • Chronic bacterial prostatitis:
    • Enterobacteriaceae (80%), Enterococcus (15%), and Pseudomonas aeruginosa
  • Chronic l prostatitis:
    • Possible role for Chlamydia, Ureaplasma urealyticum, Trichomonas vaginalis, and Mycoplasma hominis

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