Acute bacterial prostatitis is a condition primarily caused by gram-negative rods, notably E. coli and Pseudomonas species, and less frequently by gram-positive organisms like enterococci....CONTINUE READING THE FULL ARTICLE>>>
The typical infection routes involve ascent through the urethra and the reflux of infected urine into the prostatic ducts, with lymphatic and hematogenous routes considered rare…CONTINUE READING>>
Symptoms and Signs: Patients often present with perineal, sacral, or suprapubic pain, accompanied by fever and irritative voiding complaints. Obstructive symptoms may arise due to prostatic swelling, possibly leading to urinary retention.
Physical examination reveals high fevers and a notably tender prostate. Caution is urged during rectal examination to prevent septicemia, and prostatic massage is contraindicated.
Laboratory Findings: Leukocytosis with a left shift is evident in complete blood count, while urinalysis indicates pyuria, bacteriuria, and varying degrees of hematuria. Urine cultures help identify the causative pathogen.
Distinguishing acute bacterial prostatitis from conditions like acute pyelonephritis, acute epididymitis, or acute diverticulitis relies on the location of pain and thorough examination. Urinary retention due to prostatic enlargement can be discerned through rectal examination.
Hospitalization may be necessary, initiating parenteral antibiotics such as ampicillin and aminoglycoside until organism sensitivities are known. Following 24–48 hours of afebrility, oral antibiotics (e.g., quinolones if sensitive) complete a 4–6 week course.
In cases of urinary retention, a percutaneous suprapubic tube is preferred over urethral catheterization. Post-treatment, urine culture and prostatic secretion examination ensure eradication.
Effective treatment is pivotal in managing acute bacterial prostatitis. Prompt and appropriate antibiotic therapy, along with careful monitoring, contributes to a positive prognosis. Regular follow-up assessments are essential for confirming eradication and preventing recurrence…CONTINUE READING>>
