Prostatitis: Difference between revisions

Revision as of 12:41, 14 March 2011

Background

Infection of the prostate caused by gram negative organisms, 80% E. coli.

Acute Prostatitis

Symptoms: dysuria/urgency/frequency, perineal pain, low back pain, fever, chills
Rectal exam (mandatory in men with symptoms of cystitis): exquisitely tender and boggy prostate, warm to touch

Chronic Prostatitis

Relapsing UTI caused by the same organism, may have history of acute prostatitis
Symptoms: same as acute with exception of fever/chills
Rectal exam: often unremarkable

Diagnosis

UA: typically accompanied by cystitis
Urine Culture: reveals responsible bacteria
rectal exam: tender prostate gland (acute)

Work-Up

UA, Urine culture
Prostate exam
Chemistry for renal function

DDx

cystitis
pyelonephritis
chronic bacterial prostatitis

Treatment

Antibiotics: 4-6 week course
1. Cipro 500mg PO BID
2. OR Bactrim DS 1 tab PO BID
IV antibiotics (toxic prostatitis)
1. Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24
2. OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day

Disposition

Admit toxic patients or patients with urinary retention
Urology follow, chronic prostatitis may require 16 weeks of therapy

Source

Adapted from Rosens 7th Edition

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
+#Infection of the prostate caused by gram negative organisms, 80% E. coli.
+===Acute Prostatitis===
+#Symptoms: dysuria/urgency/frequency, perineal pain, low back pain, fever, chills
+#Rectal exam (mandatory in men with symptoms of cystitis): exquisitely tender and boggy prostate, warm to touch
--Infection of the prostate caused by gram negative organisms, 80% E. coli.
+===Chronic Prostatitis===
+#Relapsing UTI caused by the same organism, may have history of acute prostatitis
-Acute Prostatitis
+#Symptoms: same as acute with exception of fever/chills
+#Rectal exam: often unremarkable
--Symptoms: dysuria/urgency/frequency, perineal pain, low back pain, fever, chills
--Rectal exam (mandatory in men with symptoms of cystitis): exquisitely tender and boggy prostate, warm to touch
-Chronic Prostatitis
--Relapsing UTI caused by the same organism, may have history of acute prostatitis
--Symptoms: same as acute with exception of fever/chills
--Rectal exam: often unremarkable
 ==Diagnosis==
+#UA: typically accompanied by cystitis
+#Urine Culture: reveals responsible bacteria
--UA: typically accompanied by cystitis
+#rectal exam: tender prostate gland (acute)
--Urine Culture: reveals responsible bacteria
--rectal exam: tender prostate gland (acute)
 ==Work-Up==
+#UA, Urine culture
+#Prostate exam
--UA, Urine culture
+#Chemistry for renal function
--Prostate exam
--Chemistry for renal function
 ==DDx==
+#cystitis
+#pyelonephritis
--cystitis
+#chronic bacterial prostatitis
--pyelonephritis
--chronic bacterial prostatitis
 ==Treatment==
+#Antibiotics: 4-6 week course
+##Cipro 500mg PO BID
--Antibiotics: 4-6 week course
+##OR Bactrim DS 1 tab PO BID
+#IV antibiotics (toxic prostatitis)
-     -Cipro 500mg PO BID
+##Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24
+##OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day
-     - OR Bactrim DS 1 tab PO BID
--IV antibiotics (toxic prostatitis)
-     -Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24
-     - OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day
 ==Disposition==
+# Admit toxic patients or patients with urinary retention
+# Urology follow, chronic prostatitis may require 16 weeks of therapy
-- Admit toxic patients or patients with urinary retention
-- Urology follow, chronic prostatitis may require 16 weeks of therapy
 ==Source==
 Adapted from Rosens 7th Edition
 [[Category:GU]]