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7.08 Prostatitis


Presentation

A man complains of fever, chills, perineal or low back pain, and may have urinary urgency and frequency, as well as signs of obstruction to urinary flow ranging from a weak stream to urinary retention. On gentle examination, the prostate is swollen and tender. The infection may spread from or into, the contiguous urogenital tract (epididymis, bladder, urethra), or the bloodstream.

What to do:

What not to do:

Discussion

Not only is it difficult to obtain the organism responsible for prostatitis; it is difficult to identify an antibiotic with the correct spectrum which will also enter the prostate. Trimethoprim/sulfamethoxazole and doxycycline are alternatives.

Blood in the ejaculate may be a sign of inflammation in the prostate and epididymis or, especially in younger males, may simply be a self-limiting sequela of vigorous sexual activity.


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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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