1/130. Sonographic and MR findings of an extensive, hiv-related prostatic abscess. We present findings in a patient positive for the human immunodeficiency virus in whom a prostatic abscess involving the entire gland was diagnosed by transrectal ultrasonography and magnetic resonance imaging (MRI); he was subsequently treated by transurethral resection, drainage, and antibiotics. To our knowledge, this is the first report of a pelvic phased-array coil MRI performed in a patient with prostatic abscess. ( info) |
2/130. Primary cryptococcal prostatitis in an apparently uncompromised host. BACKGROUND: Systemic spread from a primary focus of cryptococcal infection commonly involves the central nervous system, manifested as meningitis or meningoencephalitis. Untreated meningitis and meningoencephalitis are invariably fatal, following a subacute or chronic course of cyclic remission and relapse, followed by progressive deterioration over weeks to months. Occasional patients with fulminating meningoencephalitis die within a few days. Incorrect diagnosis may be the most common cause of fatality in this disease. Thorough histopathologic examination and blood and body fluid studies should minimize misdiagnosis. methods: We studied the case of an initially misdiagnosed 64-year-old apparently immunologically competent man with primary cryptococcal prostatitis that subsequently disseminated to the central nervous system and the left eye. All immunologic findings including workup for AIDS viruses were normal. Laboratory studies confirmed cryptococcal infection. RESULTS: After initial misdiagnosis, our patient received improper treatment for 10 months. He developed meningitis and severe left endophthalmitis with optic nerve and retinal involvement. Toxic medications led to kidney insufficiency with about 66% loss of function. Following therapy, reevaluation of his immune system showed marked abnormality in cell-mediated immunity. CONCLUSIONS: cryptococcosis is easily misdiagnosed in uncompromised hosts, both clinically and pathologically, because of misconception that the disease affects only immunocompromised individuals and that primary cryptococcal prostatitis is virtually unheard-of in "normal" males. ( info) |
| PURPOSE: To refute a misconception that a prior history of prostatitis is a contraindication to prostate brachytherapy. methods AND MATERIALS: Five patients with clinical or pathologic evidence of prior prostatitis were treated with transperineal brachytherapy. Four of the patients received a single i.v. dose of ciprofloxacin (500 mg) intraoperatively. Postimplant antibiotics were not given. The pretreatment biopsy slides were reviewed. RESULTS: Two of the five patients developed postimplant urinary retention requiring short-term catheterization, and both resolved spontaneously. One patient developed what appeared to be an exacerbation of his chronic prostatitis. CONCLUSION: We continue to recommend prostate brachytherapy for the treatment of clinically organ-confined cancer, with no concern about prior clinical or pathologic evidence of prostatitis. ( info) |
| This article presents the case report of a 31-year-old patient of mine with both an inflamed prostate gland and, unknown to his doctor, premature ejaculation, both of which were treated successfully by the antibiotic ciprofloxacin. ( info) |
5/130. Short course oral prednisolone therapy in chronic abacterial prostatitis and prostatodynia: case reports of three responders and one non-responder. OBJECTIVE: To report on a small group of patients with chronic abacterial prostatitis/chronic pelvic pain syndrome treated with oral corticosteroids in order to suggest a hypothesis for a future randomised controlled trial. DESIGN: A retrospective, observational report. RESULTS: Three out of the four patients reported improvement in symptoms following steroid treatment. CONCLUSIONS: These reports suggest that there is scope for conducting a randomised, placebo controlled study to investigate the role of oral corticosteroids in patients with chronic abacterial prostatitis/chronic pelvic pain syndrome who have failed on conventional therapy. ( info) |
6/130. Cryptococcal prostatitis in a patient with chronic lymphocytic leukemia. cryptococcosis is a systemic mycosis usually affecting patients of immunodeficiency i.e. transplants recipients, patients on chemotherapy for neoplastic diseases and in those suffering from human immunodeficiency virus infection. We report a 52-year old male suffering from chronic lymphocytic leukemia (CLL) on chemotherapy who presented with fever and features of prostatism. cryptococcus neoformans infection (CN) was diagnosed on aspiration of a prostatic nodule. Subsequent investigations revealed a disseminated involvement by cryptococcus. The case represents an unusual presentation of disseminated cryptococcosis. ( info) |
7/130. Variability of the symptoms of chronic abacterial prostatitis/chronic pelvic pain syndrome during intermittent therapy with rectal prednisolone foam for ulcerative colitis. We describe the response of symptoms of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/PPS) in a man treated with rectal prednisolone for concomitant ulcerative colitis. The temporal relationship of the symptoms of CAP/PPS to starting and stopping the topical corticosteroid over 2 treatment cycles lends further anecdotal support to our hypothesis that treatment of the immune-mediated response in this chronic condition has a beneficial effect upon symptomatic outcome. ( info) |
8/130. Non-specific eosinophilic granulomatous prostatitis responded favorably to an antimicrobial agent and a hydrocortisone. A case of non-specific eosinophilic granulomatous prostatitis is presented. The patient was a 55-year-old man who was hospitalized with complaints of acute urinary retention and high-grade fever. Results of digital examination and transrectal ultrasonography of the prostate and elevated prostatic specific antigen were suggestive of prostatic cancer. Transrectal needle biopsy of the prostate was performed. Histological examination of the specimens revealed the formation of histiocytic granulomas with eosinophilic infiltration. The patient responded favorably to combination therapy with an antimicrobial agent and a hydrocortisone. ( info) |
9/130. Human-to-human transmission of pseudomonas pseudomallei. melioidosis, the clinical manifestation of infection with pseudomonas pseudomallei, has occurred infrequently in American citizens; almost all reported cases have been in vietnam veterans, usually associated with respiratory disease. A vietnam veteran from mississippi developed chronic prostatitis, with no other clinical manifestations, during service in vietnam, and P. pseudomallei was isolated from prostatic secretions 2 years after his return to the united states. The patient had had sexual contact with four women including his wife since his return from vietnam. Vaginal and cervical cultures and serum samples were obtained from the four women, and serum samples and cultures of semen were obtained from the patient. Vaginal swabs and semen cultures were negative for P. pseudomallei. The patient and his wife had hemagglutination titers (greater than 640) diagnostic of P. pseudominallei infection. This occurrence of venereal transmission is the first report of person-to-person spread of P. pseudomallei infection. ( info) |
10/130. Scrotal calcinosis presenting with prostatitis-like symptoms. A 47-year-old man complained of a constellation of prostatitis-like symptoms for 4 years. physical examination revealed a firm nodule within the scrotum. Surgical excision was performed under local anesthesia and microscopic examination confirmed scrotal calcinosis. The patient remained symptom free for at least 12 months after excision. Although the real mechanism of prostatitis-like symptoms is unknown, this rare disease may be considered in the differential diagnosis or etiologies of chronic prostatitis, and meticulous physical examination of the scrotum is necessary for patients presenting with chronic prostatitis syndrome. ( info) |