Prostatitis

Question 1

Etiology

Answer 1

o	E. Coli – MC***
o	Klebsiella
o	Enterobacter
o	Pseudomonas
o	Serratia

Question 2

5 clinical features

Answer 2

• Voiding symptoms with poorly localized pain
Fever, chills, myalgias, malaise
• Obstructive urinary symptoms
• Perineal / low back / rectum / scrotal / penis / inner part of leg
• Fever, AMS
• Prostate is firm, swollen, exquisitely tender

Question 3

3 risk factors

Answer 3

• Instrumentation
• DM
• Immunosuppression

Question 4

2 most important investigations.

Answer 4

• Urine dip for nitrite and leukocytes

* Midstream urine culture – most important

Question 5

How is urine collected for chronic bacterial prostatitis?

Answer 5

For Chronic Bacterial Prostatitis: U/Clx 4 glass specimen vs. 2 glass specimen
2 glass specimen (as effective as 4 glass):
• Midstream clean catch urine (then stop urinating)
• Post prostate massage (physician massages prostate from periphery to midline several times, then pt urinates)

Question 6

List 4 first line meds for acute prostatits

Answer 6

• Ciprofloxacin
• Levofloxacin
• Norfloxacin
• TMP / SMX

Question 7

List 4 first line meds for chronic prostatitis

Answer 7

• Ciprofloxacin
• Levofloxacin
• Norfloxacin

Question 8

List 2 second line meds for chronic prostatitis

Answer 8

• TMP/SMX

* Trimethoprim

Question 9

How to differentiate between Prostatitis and UTI

Answer 9

More likely to have fevers, chills, myalgias, and malaise in Prostatitis
If none of those symptoms than more likely to be UTI or STI