Prostatitis
Basics
Description
Description
- 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
Etiology
Etiology
- 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
- Age <35 yr:
- 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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Citation
Schaider, Jeffrey J., et al., editors. "Prostatitis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307269/all/Prostatitis.
Prostatitis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307269/all/Prostatitis. Accessed October 7, 2024.
Prostatitis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307269/all/Prostatitis
Prostatitis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 October 07]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307269/all/Prostatitis.
* Article titles in AMA citation format should be in sentence-case
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T1 - Prostatitis
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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