00:01
How about prostatitis?
It's another category
of are complicated UTI.
00:06
This occurs in about 25% of
men during their lifetime.
00:10
The common microorganisms
include gram-negative bacilli,
like E.coli
Proteus,
Klebsiella and
pseudomonas aeruginosa.
00:19
Less likely enterococci
and staph aureus,
but they can be present as well.
00:22
The pathogenesis includes
reflux of infected urine
from the urethra into
the prostatic ducts.
00:28
So in terms of how
our patient presents
with symptoms of
acute prostatitis,
it includes dysuria,
frequency, urgency,
obstructive voiding symptoms,
fever chills, and they might
complain of pelvic pain as well.
00:42
An exam the prostate
is edematous
and tender to palpation.
00:45
But please be cognizant not to
perform a prosthetic massage.
00:49
You will absolutely risk
precipitating bacteremia.
00:53
The diagnosis is going to
involve a urine analysis.
00:56
Once again,
we're going to be looking for pyuria
presence of white cells.
01:00
We also want to make sure
that we obtain a urine culture
and have sensitivities
to those microorganisms in order
to tailor antimicrobial therapy
for our patient population.
01:11
In terms of hospitalization,
same indications are
going to apply as
what we discussed in our
acute pyelonephritis.
01:18
So when our patients
are hospitalized
we typically give them
parenteral antibiotics
again, tailored to tivities
of that urine culture.
01:25
Outpatient treatment can consist
of oral fluoroquinolones.
01:29
Treatment duration in the case
of prostatitis is
often times longer
anywhere between 14 and 30 days.
01:36
These patients often times are
also co-followed by urology.