Acute prostatitis


Prostatitis is an acute bacterial infection of the prostate. Escherichia coli is the causative pathogen in 80% of cases. Other pathogens include Proteus mirabilis, Klebsiella sp, Pseudomonas aeruginosa and Enterococcus sp.

Clinical features

– Fever (often high) and chills
– Signs of cystitis (burning on urination and urinary frequency) 
– Perineal, urethral, penile or rectal pain are common

On examination:
– Very painful digital rectal examination
– Leucocyturia, pyuria, possible macroscopic haematuria

Treatment

Difficult, the infection may become chronic.

– Maintain proper hydration (1.5 litres daily)
– Fever and pain: ibuprofen PO (Chapter 1)
– Prolonged antibiotherapy:
ciprofloxacin PO: 500 mg 2 times daily for 28 days