ASCO GU 2019: treatment and management of hormone-sensitive metastatic prostate cancer
Haemophilus influenzae has been reported on rare occasions as the cause of prostatitis and urinary tract infections. Here, we report a rare case of chronic prostatitis in a year-old male with benign prostatic hypertrophy and discuss the possible underestimation of the Behandlung von Prostatitis Bronze Horseman incidence of H. This organism was identified only by its growth on chocolate agar, a medium that is not commonly used for urine cultures.
Chronic bacterial prostatitis is a sub-acute infection characterized by recurrent urinary tract infections, variable pelvic pain and voiding Behandlung von Prostatitis Bronze Horseman. Nonbacterial prostatitis and chronic pelvic pain syndrome are more common than bacterial prostatitis, and their etiologies are largely unknown.
Most urinary tract and prostate infections are caused by Gram-negative bacilli. The predominant etiologic agent in acute bacterial prostatitis and chronic bacterial prostatitis is Escherichia colifollowed Behandlung von Prostatitis Bronze Horseman species of Proteus and Providentiaand less commonly, Klebsiella, Pseudomonas, Serratiaand Enterobacter.
A case of H. This report illustrates that common clinical syndromes such as prostatitis may be associated with unusual pathogens in patients with obstructive uropathy.
A year-old Saudi man presented on the July 1,to the urology clinic complaining of urinary urgency, dysuria, frequency and burning Behandlung von Prostatitis Bronze Horseman on ejaculation. He also complained of intermittent incomplete urination accompanied by suprapubic pain.
He reported recurrent episodes of similar symptoms and chronic lower abdominal pain for the past 20 years. On January 31,the symptoms increased in severity negatively affecting his quality of life with depression that necessitated frequent visits to the psychiatry clinic.
During this period, he was diagnosed to have benign prostatic hyperplasia and chronic prostatitis and given short courses of ciprofloxacin and Xatral alfuzosin. He denied having any respiratory tract symptoms. On examination, he was generally well, and his systemic examination was normal. Per-rectal examination revealed an enlarged, painful, symmetrical smooth prostate.
Complete blood count, Urea and electrolytes, liver function test and coagulation profile were normal. Prostate specific antigen concentration was 1. Bladder ultrasonography revealed a large prostatic adenoma and ml residual urine in his bladder.
Cystoscopy showed normal urethra, mild tri-lobar prostatic enlargement with evidence of congested prostatic mucosa suggestive of chronic prostatitis. Bladder mucosa and ureteric orifices were normal. Urine obtained after prostatic massage voiding bottle 3 was sent to the microbiology laboratory for analysis and culture. Microscopic analysis of the urine specimen revealed 10 white blood cells per high power field. Overnight culture of a specimen on blood, MacConkey and chocolate agar showed no growth.
Gram-stain of the culture revealed Gram-negative coccobacilli that were oxidase positive. The organism was ampicillin, augmentin, cefuroxime, cotrimoxazole and ciprofloxacin sensitive. Accordingly, the patient was given a 3-month course of oral Augmentin mg BD. During follow-up visits, the patient showed an improvement in his urinary symptoms and a reduction of prostate size and pain on rectal examination. Microbiological cultures of the prostatic fluid taken one and 6 weeks after treatment were negative.
Few bacteria other than E. Of the patients with microbiologically proven chronic prostatitis, E. Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, GonococciGenital viruses, and occasionally mycobacteria, have all been implicated in prostatitis. Since then, nearly 33 cases that implicate H. Three patients had acute cystitis, two had prostatitis, two had pyelonephritis, and one Behandlung von Prostatitis Bronze Horseman had asymptomatic bacteriuria with pyuria.
The prostate was suspected to be the site of infection, where the oxygen is likely to be lower than that of bladder urine and permit the multiplication of organisms that require CO Behandlung von Prostatitis Bronze Horseman. Persistent severe urinary symptoms or sterile pyuria despite Behandlung von Prostatitis Bronze Horseman urine culture are Behandlung von Prostatitis Bronze Horseman the clinical symptoms, which promote the search for fastidious organisms.
Haemophilus influenzae urinary tract infections can be associated with bacteremia and lead to serious systemic complications, particularly in immunocompromised elderly patients,[ 9 ] Underlying conditions, such as chronic lung disease, malignancy, human immunodeficiency virus HIV infection, alcoholism, hypogammaglobulinemia, as well as pregnancy, increase the risk of H.
In addition, the growth of H. In suspected bacterial infections, laboratories are advised to subculture specimens onto chocolate agar. Haemophilus influenzae may be a more common uropathogen in adults than previously recognized. There should be more sensitive culture techniques, and greater physician awareness of the genitourinary pathogenicity of this bacterium, particularly in male elderly patients with anatomical or functional genitourinary abnormalities. Source of Support: Nil.
Conflict of Interest: None declared. National Center for Biotechnology InformationU. J Family Community Med. Maha M. Al-Mohizea and Fawzia E. Alotaibi 1. Fawzia E. Behandlung von Prostatitis Bronze Horseman information Copyright and License information Disclaimer. Address for correspondence: Dr. BoxRiyadhKingdom of Saudi Arabia. E-mail: as. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
This article has been cited by other articles in PMC. Abstract Haemophilus influenzae has been reported on rare occasions as the cause of prostatitis and urinary tract infections. Keywords: Chronic prostatitis, elderly, Haemophilus influenzae. Open in a separate window. Figure 1. Chocolate agar showing small watery colonies of Haemophilus influenzae. Meares EM. Prostatitis and related disorders.
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