1/40. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/40. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/40. 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.- - - - - - - - - - ranking = 1.5keywords = infection (Clic here for more details about this article) |
4/40. The perplexing problem of prostatitis.prostatitis presents the physician with a perplexing problem. It is seen often but is not easily treated. The acute form is serious but responds to antibiotic therapy. Chronic prostatitis does not respond well to any form of therapy, and opinion is divided regarding its cause. Bacterial localization tests have helped significantly in the diagnosis of chronic prostatitis. When Gram-negative organisms are found only in the prostatic fluid or in the last voided urine, bacterial prostatitis can be diagnosed. Most antibiotics, however, do not cross prostatic epithelium to combine with prostatic fluid; those that do are not effective against Gram-negative organisms. New agents hold promise but lack the test of time. While some cases of chronic disease definitely are caused by bacterial infection, most probably are not. The diagnosis in these instances is abacterial prostatitis. Treatment is symptomatic and varied. A phenomenon that adds to the mystery of etiology is the fact that antibiotics, particularly tetracycline, may help. psychotherapy often is needed but seldom is accepted. The physician must rule out underlying causes, such as a physical abnormality of the urinary system, for any form of prostatitis before considering it an isolated disorder.- - - - - - - - - - ranking = 7.5284630839173keywords = bacterial infection, infection (Clic here for more details about this article) |
5/40. Nocardia prostatitis in a small intestine transplant recipient.A 37-year-old small bowel transplant recipient with a history of urolithiasis was admitted for dysuria after passing a urinary stone. His laboratory evaluation showed increased blood urea nitrogen and creatinine. urinalysis showed increased white blood cells and positive leukocyte esterase. A computed tomography scan revealed signs of urinary tract obstruction and prostatic enlargement. He failed to respond initially to empiric antibiotic treatment with ciprofloxacin and ampicillin sulbactam while waiting for culture results. The pathogen recovered from both urine and blood culture was subsequently identified as nocardia asteroides complex. The isolate was sensitive to ceftriaxone and sulfa but resistant to ciprofloxacin. The patient improved on ceftriaxone and trimethoprim-sulfamethoxazole and completed a 6-month course without any relapse. Nocardia prostatitis is an uncommon infection and must be treated with a long course of antibiotics guided by susceptibility testing.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
6/40. cytomegalovirus prostatitis.Tissue demonstration of cytomegalovirus (CMV) within the male genital tract has rarely been reported. We present a case of extensive CMV prostatitis in a homosexual patient with acquired immune deficiency syndrome (AIDS) dying of disseminated CMV infection.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
7/40. Granulomatous prostatitis due to mycobacterium avium complex.Granulomatous infections of the genitourinary tract are rare, especially those caused by nontuberculous mycobacteria. A case of prostatitis due to mycobacterium avium complex in an immunocompetent man is reported. The patient had sterile pyuria, and a Mantoux skin test, using 5 tuberculin units, was positive (induration, 10 mm in diameter). Pathologic examination of the prostate revealed necrotizing granulomata with acid-fast bacilli, and repeated performance of urine cultures before initiating therapy yielded M. avium complex.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
8/40. Nonspecific granulomatous prostatitis.Nonspecific granulomatous prostatitis is a relatively rare disorder of the prostate. We encountered 4 cases of this type of chronic inflammation, including 1 case of xanthogranulomatous prostatitis. In all cases the diagnosis was made by histologic examination of specimens obtained by transurethral resection, retropubic prostatectomy, or transrectal needle biopsy. Echography revealed a hypoechoic lesion in the case of xanthogranulomatous prostatitis, while the other cases showed no specific findings except for the associated adenomas. The major symptoms were frequency and dysuria caused by urinary tract infection or benign prostatic hyperplasia associated with the granulomatous prostatitis.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
9/40. Pathologic features of necrotizing adenoviral prostatitis in an AIDS patient.Adenovirus has been implicated as a cause of opportunistic infections in immunocompromised patients, frequently with multiorgan involvement and a fatal outcome. We describe a case of necrotizing adenoviral prostatitis in a 35-year-old man with terminal AIDS and generalized adenoviral infection. The histopathologic findings of intraacinar necrotizing inflammation, prominent viral nuclear inclusions in residual epithelium, and mild T-lymphocyte and macrophageal inflammatory reaction were observed in the prostate. The presence of adenovirus was confirmed by electron microscopy and immunohistochemistry. Squamous metaplasia was present in the surrounding acini. This case of adenoviral prostatitis appears to be the first report of its kind in medical literature and demonstrates another aspect of the diversity of organ manifestations seen in this infection. This lesion should be included in the differential diagnosis of necrotizing prostatic diseases.- - - - - - - - - - ranking = 1.5keywords = infection (Clic here for more details about this article) |
10/40. Subclinical prostatic inflammation attributable to chlamydia trachomatis in a patient with prostate cancer.Chronic inflammation has long been linked to cancers with an infectious etiology. Subclinical intraprostatic inflammation is a frequent finding in prostatic specimens obtained during surgical procedures. Recent studies using biomolecular (amplification) methods showed that the incidence of cryptic bacterial infections of prostate gland may be underestimated. We present the case of 66 years old man with no symptoms of prostatitis in whom chronic chlamydia trachomatis infection was diagnosed based on the patient's medical history and detection of chlamydial dna in prostate biopsy specimen by means of ligase chain reaction. Two years later the patient was diagnosed with prostate cancer on repeated prostate biopsy.- - - - - - - - - - ranking = 8.0284630839173keywords = bacterial infection, infection (Clic here for more details about this article) |
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