++
+++
Essentials of Diagnosis
++
Fever
Irritative voiding symptoms
Perineal or suprapubic pain
Exquisite tenderness on rectal examination
Positive urine culture
+++
General Considerations
++
++
Perineal, sacral, or suprapubic pain
Fever
Irritative voiding complaints
Obstructive symptoms
Urinary retention
Exquisitely tender prostate
+++
Differential Diagnosis
++
Epididymitis
Diverticulitis
Urinary retention from benign or malignant prostatic enlargement
Chronic bacterial prostatitis
Nonbacterial prostatitis
Chronic pelvic pain syndrome
++
Complete blood count: leukocytosis and a left shift
Urinalysis: pyuria, bacteriuria, hematuria
Urine culture: positive
++
++
Intravenous ampicillin and an aminoglycoside until afebrile for 24–48 hours, then oral quinolone for 4–6 weeks
Ampicillin, 1 g intravenously every 6 hours, and gentamicin, 1 mg/kg intravenously every 8 hours for 21 days
Ciprofloxacin, 750 mg orally every 12 hours for 21 days
Ofloxacin, 200–300 mg orally every 12 hours for 21 days
Trimethoprim-sulfamethoxazole, 160/800 mg orally every 12 hours for 21 days (increasing resistance noted [up to 20%])
+++
Therapeutic Procedures
++
++
++
++
++
+
Kwan
ACF
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Lupo
F
et al. Is bacterial prostatitis a urinary tract infection? Nat Rev Urol. 2019;16:203.
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Shakur
A
et al. Prostatitis: imaging appearances and diagnostic considerations. Clin Radiol. 2021;76:416.
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Xiong
S
et al. Pharmacological interventions for bacterial prostatitis. Front Pharmacol. 2020;11:504.
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