Acute bacterial prostatitis

Background

Microbiology

• Enterobacterales, mostly Escherichia coli, Klebsiella, and Proteus
• Other bacteria, including Pseudomonas aeruginosa, Enterobacter, and Staphylococcus aureus
• Mycobacterium tuberculosis, especially with sterile pyuria
• Rare: Burkholderia pseudomallei, Corynebacterium glucuronlyticum, fungi, viruses

Risk Factors

• Other GU infections: UTI, orchitis, epididymitis, urethritis
• Obstruction: BPH, phimosis, urethral stricture
• Procedure: catheterization, cystoscopy, transurethral resection, prostate biopsy
• Pelvic trauma

Clinical Manifestations

• Irritative urinary symptoms: frequency, urge incontinence, and urgency
• Pelvic or perineal pain
• Sexual dysfunction with painful ejaculation and postcoital pelvic discomfort
• May have systemic signs, including fever and bacteremia

Management

• Treat as UTI with a general preference for fluoroquinolones and duration 10 to 14 days