Pseudomonas Prostatitis Causing Fever of Unknown Origin
We generally think of bacterial prostatitis as an immediately recognizable illness of troubling symptoms. It turns out that this is not always the case.
A case report just published in next month's Clinical Nuclear Medicine details the story of a 45-year old man in Taiwan who presented to his doctors with fever of unknown origin (FUO). Upon testing with a PET CAT scan, he was found to have activity in the rear of his prostate, on both sides.
A blood test showed that he had a high prostate-specific antigen (PSA) and his urine grew Pseudomonas bacteria after a vigorous massaging of his prostate. A trans-rectal prostate biopsy showed inflammation. The patient was treated with Ciprofloxacin antibiotics and his fever resolved. His urinalysis and PSA then normalized.
Lesson learned: Prostatitis, as defined here by inflammatory cells, high PSA, and infected urine, does not always require diagnostic symptoms. Actually, it's rather remarkable that it took a PET scan to diagnose prostatitis, which ordinarily is a very symptomatic illness.
What is even more remarkable is that the doctors put a needle into a prostate of a man with fever and urine infection. There was a very real risk of causing sepsis and putting his life at risk. So this case ended well. But a word to the wise: If you have febrile prostatitis, be very cautious about accepting a needle put into it and definitely before you've been started on antibiotics.
A case report just published in next month's Clinical Nuclear Medicine details the story of a 45-year old man in Taiwan who presented to his doctors with fever of unknown origin (FUO). Upon testing with a PET CAT scan, he was found to have activity in the rear of his prostate, on both sides.
A blood test showed that he had a high prostate-specific antigen (PSA) and his urine grew Pseudomonas bacteria after a vigorous massaging of his prostate. A trans-rectal prostate biopsy showed inflammation. The patient was treated with Ciprofloxacin antibiotics and his fever resolved. His urinalysis and PSA then normalized.
Lesson learned: Prostatitis, as defined here by inflammatory cells, high PSA, and infected urine, does not always require diagnostic symptoms. Actually, it's rather remarkable that it took a PET scan to diagnose prostatitis, which ordinarily is a very symptomatic illness.
What is even more remarkable is that the doctors put a needle into a prostate of a man with fever and urine infection. There was a very real risk of causing sepsis and putting his life at risk. So this case ended well. But a word to the wise: If you have febrile prostatitis, be very cautious about accepting a needle put into it and definitely before you've been started on antibiotics.
Posted by Arnon_Krongrad_MD at 10/15/2010 12:30 AM 
Categories: Infection
Tags: bacteria cases antibiotics diagnosis
Categories: Infection
Tags: bacteria cases antibiotics diagnosis
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