1/6. 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 = 1keywords = bacterial infection (Clic here for more details about this article) |
2/6. 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 = 1keywords = bacterial infection (Clic here for more details about this article) |
3/6. Two case reports of bacterial prostatitis with a proposed treatment for aviators.Bacterial prostatitis is the inflammation of the prostate gland secondary to a bacterial infection, characteristically having a chronic course with sporadic acute exacerbations. While considered to be the most common cause of recurrent bacterial urinary tract infections in the middle-aged adult male, bacterial prostatitis can be difficult to manage satisfactorily, particularly from the aeromedical perspective. The recurrent infection pattern, common for chronic bacterial prostatitis, has recently been better defined with the localization of the bacterial reservoir as being within the lumen of the prostatic ducts. Capitalizing upon "passive ion trapping" of certain lipid soluble antibiotics in this "protected" site, a two-phased, nonsurgical, pharmacological treatment is proposed for aviators. Two representative cases are reported that demonstrate such management within the setting of an operational USAF flight surgeon's office.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/6. The characterization of bacterial and nonbacterial prostatitis by prostatic immunoglobulins.Although inflammatory diseases of most human secretory surfaces are difficult to investigate clinically, the secretory immune system of the human prostate may be studied relatively easily because prostatic fluid may be obtained from the gland by digital massage. We studied inflammatory conditions of the prostate to establish whether we could use the humoral immune response to differentiate these conditions. Using a sensitive solid-phase radioimmunoassay, we measured total IgA and IgG, and IgA and IgG antibodies to enterobacteriaceae in the serum and prostatic fluid of men with and without prostatic inflammation. These studies show that levels of IgA and IgG in the prostatic fluid of men with bacterial prostatitis are higher than those in men without histories of urinary or prostatic infections. In men with bacterial prostatitis, prostatic antibodies to enterobacteriaceae were elevated 12 to 18 months after curative treatment and indefinitely after ineffective treatment; anti-Enterobacteriaceal IgG levels returned to normal after infection only with cure. Total IgA and IgG in the prostatic fluid of men with nonbacterial prostatitis--men who have signs of prostatic inflammation without evidence of old or ongoing bacterial infection--are also higher than levels found in uninfected individuals. Although this finding supports an inflammatory etiology for the symptoms seen in nonbacterial prostatitis, no significant IgA or IgG Enterobacteriaceal antibody titers were detected in these patients. This excludes a remote Enterobacteriaceal infection as a cause of nonbacterial prostatitis. These observations confirm that the prostate gland is a distinct part of the male secretory immune system.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
5/6. longitudinal studies of prostatic fluid immunoglobulin in men with bacterial prostatitis.To better characterize the apparent secretory immune response of the prostate to bacterial infection of the genitourinary tract, we assayed serial expressed prostatic secretion (EPS) specimens for total and antibacterial immunoglobulin. Three men with bacterial prostatitis, including 2 otherwise healthy men with chronic infections and 1 man with IgG multiple myeloma and an acute infection, were studied. In the former 2 cases the infections were associated with greater increases in total EPS IgA than total EPS IgG or IgM. The patient with multiple myeloma had markedly elevated serum IgG levels and subnormal serum IgA and IgM levels and the acute infection was accompanied by increases in total EPS IgG and IgM but consistently low total EPS IgA. Antibacterial EPS IgA, which was measurable in each case, was always quantitatively greater than antibacterial EPS IgG. Antibacterial IgM was never detectable. Alterations in the concentrations of antibacterial EPS IgG and IgA were generally not associated with comparable alterations of total EPS IgG and IgA, respectively, and the concentrations of antibacterial EPS IgG and IgA did not correlate well with the clinical or bacteriologic response to antimicrobial therapy. The concentration of antibacterial IgA expressed as a function of total IgA was as much as 1550 times greater in the EPS than in the serum. However, the relative concentrations of antibacterial IgG and IgM were similar in the EPS and serum. These data suggest local synthesis of antibacterial IgA in the prostate that persists following eradication of the infection and that is regulated independent of both the systemic immune response and the concentration of total prostatic fluid immunoglobulin.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/6. Use of a solid-phase radioimmunoassay and formalin-fixed whole bacterial antigen in the detection of antigen-specific immunoglobulin in prostatic fluid.The prostatic fluid of two patients with escherichia coli bacterial prostatitis was analyzed for evidence of a local immune response to bacterial infection. A solid-phase radioimmunoassay was modified to measure the immunoglobulin (Ig)A and IgG antigen-specific antibody responses to infecting bacteria in serum and prostatic fluid from patient. Formalin-fixed whole E. coli were used as antigen. In one patient with acute E. coli prostatic infection, measurements of antigen-specific antibody confirm the presence of a systemic and local immune response. However, in another patient with a chronic E. coli prostatitis, a primarily local immune response was demonstrated. The response measured in the prostatic fluid appears to be locally stimulated and specific for the infecting bacteria. Furthermore, IgA was the predominant immunoglobulin involved in the local prostatic immune response to infection. Although elevations of serum IgA antigen-specific antibody levels were short-liver after treatment of prostatic infection, local IgA antigen-specific antibodies were detected for as long as 1 yr after the initial infection in both patients studied.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |