Acute prostatitis

Case report:

A 78-year-old patient comes in poor general condition into practice and complains about the last two days lasting high fever and dysuria, nocturia, urinary frequency, pain in the lower lumbar spine and the dam. Preceded two weeks earlier had a cystoscopy because of a conspicuous Harnsedimentes and suspected bladder stones.

Diagnosis:

Physical examination confirms the initially significantly increased body temperature with 39.1 � C sublingually; persists in the rectal exam a significantly enlarged, edematous swollen and very painful prostate. Microscopic examination of the midstream urine gives a leucocyturia and bacteriuria. Microbiologically 106 can be detected per mL Escherichia coli with resistance to cotrimoxazole (various trade names); Ofloxacin (Tarivid others) and ciprofloxacin (Cipro, etc.) are effective. On the investigation of a prostate secretion with the necessary for this prostate massage is deliberately avoided because of the possible induction of bacteremia.

Pathogenesis:

Bacterial pathogens reach the prostate through the urethra usually ascendant, also on an intra-urethral reflux of infected urine, a lymphatic spread from the rectum or directly by the settlement as part of a cystoscopic procedure. Such an intervention may have been causally involved in occurred here prostatitis.

Therapy:

Acute bacterial prostatitis is a serious disease with significant systemic impact and should therefore be treated specifically and intensively.
A relatively long treatment time is necessary to also avoid a transition into chronic prostatitis. In the present constellation 500 mg twice daily ciprofloxacin (Cipro, etc.) is prescribed for four weeks.