Snapshot A 60-year-old man with a history of benign prostatic hyperplasia presents to his primary care physician for a 3-day period of fever, chills, and pain with urination. He was recently catheterized during an admission in the hospital. Physical exam reveals a tender and enlarged prostate on digital rectal exam. Urinalysis reveals pyuria and hematuria. He is started on empiric antibiotics. Introduction Clinical definition infectious or non-infectious inflammation of prostate acute prostatitis typically infectious < 35 years of age login to view 1 more bullet > 35 years of age login to view 1 more bullet chronic prostatitis can be due to recurrent infections lasting > 3 months (10% of chronic prostatitis) can be due to chronic pelvic pain (90% of chronic prostatitis) login to view 3 more bullets Epidemiology incidence 10-15% men have it once in their lifetime risk factors catheterization benign prostatic hypertrophy Presentation Symptoms dysuria urinary frequency urinary urgency straining with urination or interrupted stream (obstruction) lower back pain Physical exam fever chills digital rectal exam enlarged prostate very tender on exam may indicate acute prostatitis less tender on exam may indicate chronic prostatitis Studies Urine studies for bacterial infection urinalysis pyuria hematuria urine culture Differential Urinary tract infection Urethritis Treatment Medical antibiotics indications login to view 1 more bullet drugs chosen empirically based on local resistance patterns login to view 6 more bullets α-blockers indications login to view 2 more bullets drugs login to view 1 more bullet Complications Prostatic abscess