Acute Bacterial Prostatitis Flashcards
Acute … … refers to a an infection involving the prostate that may cause significant systemic upset.
Acute bacterial prostatitis refers to a an infection involving the prostate that may cause significant systemic upset.
Acute bacterial prostatitis presents with…
It tends to present with urinary symptoms, lower back or pelvic pain +/- symptoms of systemic infection.
… is the most commonly isolated pathogen in acute bacterial prostatitis.
E.coli is the most commonly isolated pathogen in acute bacterial prostatitis.
E.coli is the most commonly isolated pathogen in acute bacterial prostatitis - but what else may be causes?
Pseudomonas aeruginosa, Klebsiella, Enterococcus and Proteus may all be causes. Sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoea, are less commonly isolated.
Recent urethral or prostatic instrumentation (e.g. urethral catheterisation, cystoscopy or transrectal prostate biopsy): rarely acute … … may follow instrumentation of the urethra or prostatic interventions. Multiple or uncommon pathogens are more likely to be isolated in these cases.
Recent urethral or prostatic instrumentation (e.g. urethral catheterisation, cystoscopy or transrectal prostate biopsy): rarely acute bacterial prostatitis may follow instrumentation of the urethra or prostatic interventions. Multiple or uncommon pathogens are more likely to be isolated in these cases.
Disseminated infection: acute bacterial … may also occur secondary to disseminated infection with a distant source. Bacteria like S.aureus may exhibit ‘metastatic’ spread to multiple locations throughout the body including the ….
Disseminated infection: acute bacterial prostatitis may also occur secondary to disseminated infection with a distant source. Bacteria like S.aureus may exhibit ‘metastatic’ spread to multiple locations throughout the body including the prostate.
Acute bacterial prostatitis often presents with … symptoms, pain and features of … ….
Acute bacterial prostatitis often presents with urinary symptoms, pain and features of systemic infection.
Symptoms of acute bacterial prostatitis: (8)
Dysuria Urinary frequency Perineal, rectal or pelvic pain Back pain Urinary retention Fevers Myalgia Malaise
Signs of acute bacterial prostatitis: (4)
Tender, hot, swollen prostate (on DRE)
Palpable bladder (if in urinary retention)
Tachycardia
Pyrexia
What investigations are done for acute bacterial prostatitis? (Specify bloods. Cultures, … checks and imaging?)
Bloods:
FBC
U&Es
CRP
Cultures:
Mid-stream urine
Semen culture
Blood culture
STIs:
Men should be evaluated for sexually transmitted infections. Routine screening for blood-borne viruses may also be organised.
Imaging:
MRI prostate: allows assessment of the prostate and to screen for the development of an abscess.
Management of acute bacterial prostatitis?
Most cases will respond to appropriate antibiotics.
Patients presenting with sepsis must be managed with the principles outlined by the ‘sepsis six’ and receive an urgent senior review.
Patients with significant co-morbidities, signs of systemic infection or another cause for concern should be admitted for inpatient therapy and monitoring.
How long are antibiotic courses usually for acute bacterial prostatitis?
Antibiotics courses are typically 14 days. IV antibiotics should be reserved for patients with a significant infection under microbiology guidance.
First line ABs for acute bacterial prostatitis?
First line: Oral ciprofloxacin 500 mg twice daily or ofloxacin 200 mg twice daily
Second line Abs for acute bacterial prostatitis?
Second line: Oral levofloxacin 500 mg once daily, or co-trimoxazole 960 mg twice daily
NOTE: All patients being prescribed fluoroquinolones (e.g. ciprofloxacin, ofloxacin or levofloxacin) should be counseled on the risk of fluoroquinolone-induced tendon …. They should be avoided in patients with a history of tendon … related to quinolones or seizures.
NOTE: All patients being prescribed fluoroquinolones (e.g. ciprofloxacin, ofloxacin or levofloxacin) should be counseled on the risk of fluoroquinolone-induced tendon rupture. They should be avoided in patients with a history of tendon rupture related to quinolones or seizures.
