 acute prostatitis. How does it present? How do you treat it? And what is it? Hey guys, my name is Boris. I'm a physician assistant continuing on day four of our PANTS review, physician assistant national certifying exam review, taking another note card from my gigantic stack of PANTS note cards that I personally use to study. Today's note card is going to be acute prostatitis. How does it present? How do you treat it? And what is it? Okay, so I don't think I have to explain to you what the prostate is. You probably know that it's a gland kind of in circles. I don't know what word I'm looking for, but it goes around the urethra. Sometimes it's large and it kind of pinches off the urethra causing retention and difficult urination in usually older males. Well, all males because females don't have a prostate, but usually older males, you know, 60 and above come to you with these prostate issues. However, prostatitis is a whole different beast. All right, prostatitis is in an infection of the prostate via urine backflow. So it's kind of like a urinary tract infection, E. coli or whatever bugs cause a urinary tract infection, except it's due to backflow going back up the urethra going into the prostate and then infecting the prostate itself. So this is not a bladder infection. It's not a kidney infection. It's a prostate infection, prostatitis. Okay, most common bugs above 35 years old, the same as a lower UTI is E. coli. Under 35 years old is again the same as a bladder infection. The most common bugs are chlamydia or gonorrhea, unless of course the patient is not sexually active, then it goes back to E. coli. So most of these are probably going to be older people and the cause is most likely going to be E. coli. Sorry about that. Younger people, if they are sexually active, then you're looking for chlamydia gonorrhea, but also, of course, not forgetting about the possibility of E. coli. Okay, so symptoms of acute prostatitis. Pioria. Pioria is the presence of pus in the urine. Okay, so basically discharge from the urethra, that kind of situation, thick kind of goopy stuff coming out of the urine. So pioria, fever, myalgias, so muscle aches, you know, food like symptoms, chills, body aches, that kind of situation. Prostate is tender and boggy. It's kind of like soft. It's, I don't know how you would explain boggy, but it's just like, it doesn't feel right, it doesn't feel firm like it normally does. It feels kind of more soft and it's tender. Perineal, so perineum is the kind of the area between the legs below the groin, so below the scrotum. That's the perineal area. So pain there and or back pain, you know, radiating to the back. Treatment is four to six weeks on Bactrum or a Fluoroquinolone, like Ciprofloxacin, Moxifloxacin. I'm not sure about Moxia actually. Cipro, I think would be a good choice for this one or Bactrum. So that was a lot of information and I'm getting tired, so I probably didn't communicate it very clearly, but acute prostatitis is an infection of the prostate due to backflow of infected urine into the prostatic ducts, most common bugs. Under 35 years old are Chlamydia gonorrhea. If the person is sexually active, most common bugs for over 35 years old is E. Coli. Symptoms are Pyuria, so plus in the urine, fever, myalgias, you know, fever, chills, body aches, a tender, boggy prostate and perineal pain and or back pain. Treatment is four to six weeks on Bactrum or a Fluoroquinolone. So it's a pretty long treatment to get the prostate treated. All right, guys. What else did I want to say about prostatitis? I think I may have seen a case of this in urgent care not too, too long ago. You know, older gentlemen, I think 60s or 70s came in with fever. No upper respiratory symptoms, no coughs, no ear infections, no like very common causes of fever, but he did say that it's harder and harder to pee and it doesn't really hurt to pee. He kind of has to just put in more effort to start the stream. So he's got some resistance, but this is new. So benign prostatic hypertrophy, BPH, doesn't just come out of nowhere. It kind of ramps up gradually over days, probably more like months to years, whereas this came on over the course of two days. So it made me think, okay, what's an acute cause of enlarged prostate, okay, prostatitis, especially having to do with fever is a possibility. What I unfortunately had to end up doing with this guy is sent him to the hospital because he had a lot of other risk factors, you know, diabetic, elderly, he had a fever already. So I didn't know if there happens to be an abscess there. It's not an area you really want to mess with because you don't want for knees gangrene to develop because an infection spreading in that area is very, very dangerous, could be even life-threatening. So basically I had to send him to the hospital, but that being said, I also prescribed him a couple of weeks of Bactrum and had him follow up with his PCP as soon as possible, as soon as he was discharged from the hospital because he needs a prolonged course of Bactrum if he's not allergic to it. So all that to be said, acute prostatitis, infection of the prostate, the end. Okay, see you guys in the next video. Peace.