WordNet

of critical importance and consequence; "an acute (or critical) lack of research funds"
having or demonstrating ability to recognize or draw fine distinctions; "an acute observer of politics and politicians"; "incisive comments"; "icy knifelike reasoning"; "as sharp and incisive as the stroke of a fang"; "penetrating insight"; "frequent penetrative observations" (同)discriminating, incisive, keen, knifelike, penetrating, penetrative, piercing, sharp
extremely sharp or intense; "acute pain"; "felt acute annoyance"; "intense itching and burning" (同)intense
having or experiencing a rapid onset and short but severe course; "acute appendicitis"; "the acute phase of the illness"; "acute patients"
of an angle; less than 90 degrees
inflammation of the prostate gland characterized by perineal pain and irregular urination and (if severe) chills and fever

PrepTutorEJDIC

(先の)『鋭い』,とがった / (痛み・感情などが)『激しい』,強い / (知力・感覚などが)『鋭い』,鋭敏な / (事態が)重大な / (病気が)急性の / (音が)高い,鋭い / 鋭角の
前立腺炎

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/24 20:30:46」(JST)

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Acute prostatitis is a serious bacterial infection of the prostate gland. This infection is a medical emergency. It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

Signs and symptoms

Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract, as evidenced by white blood cells and bacteria in the urine. Acute prostatitis may be a complication of prostate biopsy.^[1] Often, the prostate gland is very tender to palpation through the rectum.^[2]

Diagnosis

Micrograph showing a neutrophilic infiltration of prostatic glands - the histologic correlate of acute prostatitis. H&E stain.

Acute prostatitis is relatively easy to diagnose due to its symptoms that suggest infection. The organism may be found in blood or urine, and sometimes in both.^[1] Common bacteria are Escherichia coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Enterococcus, Serratia, and Staphylococcus aureus. This can be a medical emergency in some patients and hospitalization with intravenous antibiotics may be required. A complete blood count reveals increased white blood cells. Sepsis from prostatitis is very rare, but may occur in immunocompromised patients; high fever and malaise generally prompt blood cultures, which are often positive in sepsis. A prostate massage should never be done in a patient with suspected acute prostatitis, since it may induce sepsis. Since bacteria causing the prostatitis is easily recoverable from the urine, prostate massage is not required to make the diagnosis. Rectal palpation usually reveals an enlarged, exquisitely tender, swollen prostate gland, which is firm, warm, and, occasionally, irregular to the touch. C-reactive protein is elevated in most cases.^[3]

Prostate biopsies are not indicated as the (clinical) features (described above) are diagnostic. The histologic correlate of acute prostatitis is a neutrophilic infiltration of the prostate gland.

Acute prostatitis is associated with a transiently elevated PSA, i.e., the PSA is increased during an episode of acute prostatitis and then decreases again after it has resolved. PSA testing is not indicated in the context of uncomplicated acute prostatitis.

Treatment

Antibiotics are the first line of treatment in acute prostatitis (Cat. I). Antibiotics usually resolve acute prostatitis infections in a very short time, however a minimum of two to four weeks of therapy is recommended to eradicate the offending organism completely.^[4] Appropriate antibiotics should be used, based on the microbe causing the infection. Some antibiotics have very poor penetration of the prostatic capsule, others, such as Ciprofloxacin, Co-trimoxazole and tetracyclines such as doxycycline penetrate well. In acute prostatitis, penetration of the prostate is not as important as for category II because the intense inflammation disrupts the prostate-blood barrier. It is more important to choose a bacteriocidal antibiotic (kills bacteria, e.g. quinolone) rather than a bacteriostatic antibiotic (slows bacterial growth, e.g. tetracycline) for acute potentially life-threatening infections.^[5] Severely ill patients may need hospitalization, while nontoxic patients can be treated at home with bed rest, analgesics, stool softeners, and hydration. Patients in urinary retention are best managed with a suprapubic catheter or intermittent catheterization. Lack of clinical response to antibiotics should raise the suspicion of an abscess and prompt an imaging study such as a transrectal ultrasound (TRUS).^[6]

Prognosis

Full recovery without sequelae is usual.

References

^ ^a ^b Stoica G, Cariou G, Colau A et al. (2007). "[Epidemiology and treatment of acute prostatitis after prostatic biopsy]". Prog. Urol. (in French) 17 (5): 960–3. doi:10.1016/S1166-7087(07)92397-0. PMID 17969797.
^ Goldman, Lee (2011). Goldman's Cecil Medicine (24th ed.). Philadelphia: Elsevier Saunders. p. 808. ISBN 1437727883.
^ Auzanneau C, Manunta A, Vincendeau S, Patard JJ, Guillé F, Lobel B (2005). "[Management of acute prostatitis, based on a series of 100 cases]". Prog. Urol. (in French) 15 (1): 40–4. PMID 15822390.
^ "Treatment of Prostatitis". AAFP Prostatitis Treatment Article
^ Hua VN, Schaeffer AJ (2004). "Acute and chronic prostatitis". Med. Clin. North Am. 88 (2): 483–94. doi:10.1016/S0025-7125(03)00169-X. PMID 15049589.
^ Göğüş C, Ozden E, Karaboğa R, Yağci C (2004). "The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess". European journal of radiology 52 (1): 94–8. doi:10.1016/S0720-048X(03)00231-6. PMID 15380852.

External links

Prostatitis at DMOZ

Additional images

Prostate, urethra, and seminal vesicles.
The arteries of the pelvis.
Male pelvic organs seen from right side.

UpToDate Contents

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1. 急性細菌性前立腺炎 acute bacterial prostatitis
2. 慢性細菌性前立腺炎 chronic bacterial prostatitis
3. 成人男性における排尿困難に対するアプローチ approach to dysuria in the adult man
4. 慢性前立腺炎/慢性骨盤痛症候群 chronic prostatitis chronic pelvic pain syndrome
5. 男性の性交時痛 male dyspareunia

English Journal

Chronic baseline prostate inflammation is associated with lower tumor volume in men with prostate cancer on repeat biopsy: Results from the REDUCE study.

Moreira DM1, Nickel JC2, Andriole GL3, Castro-Santamaria R4, Freedland SJ5.
The Prostate.Prostate.2015 Sep;75(13):1492-8. doi: 10.1002/pros.23041. Epub 2015 Jul 17.
BACKGROUND: To evaluate whether baseline acute and chronic prostate inflammation among men with initial negative biopsy for prostate cancer (PC) is associated with PC volume at the 2-year repeat prostate biopsy in a clinical trial with systematic biopsies.METHODS: Retrospective analysis of 886 men w
PMID 26184556

Bacterial Prostatitis Enhances 2-Amino-1-Methyl-6-Phenylimidazo[4,5-b]Pyridine (PhIP)-Induced Cancer at Multiple Sites.

Sfanos KS1, Canene-Adams K2, Hempel H2, Yu SH2, Simons BW3, Schaeffer AJ4, Schaeffer EM3, Nelson WG5, De Marzo AM6.
Cancer prevention research (Philadelphia, Pa.).Cancer Prev Res (Phila).2015 Aug;8(8):683-92. doi: 10.1158/1940-6207.CAPR-15-0090. Epub 2015 May 19.
Dietary carcinogens, such as 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), and chronic inflammation have each been implicated as etiologic agents in prostate cancer. We hypothesized that bacterial prostatitis would accelerate PhIP-induced preinvasive lesions in the rat prostate. Male Fisch
PMID 25990088

Japanese Journal

経尿道的前立腺核出術（transurethral enucleation with bipolar：TUEB）における術後有熱性尿路性器感染症発生頻度についての検討

Japanese Journal of Endourology 28(2), 317-321, 2015
NAID 130005107373

単純性肝嚢胞内へ浸潤性発育を示した肝細胞癌肝内転移の1例

日本臨床外科学会雑誌 76(4), 863-867, 2015
NAID 130005106567

Related Pictures

★リンクテーブル★

リンク元	「前立腺炎」
関連記事	「acute」

「前立腺炎」

Acute Prostatitis
Classification and external resources
ICD-10	N41.0
ICD-9	601.0
DiseasesDB	10801
MedlinePlus	000519
eMedicine	med/2845
MeSH	D011472

　　[★]

英: prostatitis
関: 前立腺

分類

急性前立腺炎 acute prostatitis　(NIH分類)カテゴリーI
慢性細菌性前立腺炎 chronic bacterial prostatitis　(NIH分類)カテゴリーII
慢性非細菌性前立腺炎 chronic nonbacterial prostatitis　(NIH分類)カテゴリーIIIA

最も多い

前立腺痛 prostatodynia　(NIH分類)カテゴリーIIIB

前立腺炎のためのNIH分類

型	分類		症状
I	急性細菌性前立腺炎		発熱、排尿痛、全身倦怠で急激に発症
II	慢性細菌性前立腺炎		Iが慢性化したもの。再発性細菌感染としての症状を認める。
III	慢性非細菌性前立腺炎		頻尿・残尿感、排尿時痛（不快感）、ソケイ部・会陰部・尿道部痛など多彩。
	慢性骨盤内疼痛症候群/前立腺関連疼痛症候群
		A 炎症性
		B 非炎症性
IV	無症候性炎症性前立腺炎		たまたま採取した前立腺液中に白血球を認めて発見されるなど、偶然発見されることがあるが、現時点では積極的に治療の必要はない。

「acute」

　　[★]

adj.

(疾患)急性の、急性型の、急性的な。(形状が)鋭い、鋭角の。(感覚、才知などが)鋭い。明敏な、鋭い眼識のある。

関: acutely、quick、sharp

[pmid17969797-1] Stoica G, Cariou G, Colau A et al. (2007). "[Epidemiology and treatment of acute prostatitis after prostatic biopsy]". Prog. Urol. (in French) 17 (5): 960–3. doi:10.1016/S1166-7087(07)92397-0. PMID 17969797.

[Cecil-2] Goldman, Lee (2011). Goldman's Cecil Medicine (24th ed.). Philadelphia: Elsevier Saunders. p. 808. ISBN 1437727883.

[pmid15822390-3] Auzanneau C, Manunta A, Vincendeau S, Patard JJ, Guillé F, Lobel B (2005). "[Management of acute prostatitis, based on a series of 100 cases]". Prog. Urol. (in French) 15 (1): 40–4. PMID 15822390.

[AAFP-4] "Treatment of Prostatitis". AAFP Prostatitis Treatment Article

[pmid15049589-5] Hua VN, Schaeffer AJ (2004). "Acute and chronic prostatitis". Med. Clin. North Am. 88 (2): 483–94. doi:10.1016/S0025-7125(03)00169-X. PMID 15049589.

[pmid15380852-6] Göğüş C, Ozden E, Karaboğa R, Yağci C (2004). "The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess". European journal of radiology 52 (1): 94–8. doi:10.1016/S0720-048X(03)00231-6. PMID 15380852.

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案内

案内

acute prostatitis