Servicio de Medicina Interna, Hospital Clínico, Complejo Hospitalario Universitario de Salamanca, Salamanca, Spain.
Eur J Clin Microbiol Infect Dis. 2013 Feb;32(2):263-8. doi: 10.1007/s10096-012-1738-z. Epub 2012 Sep 6.
According to the literature, prostatitis is a rare cause of prolonged fever without an apparent origin. However, this syndrome can be easily diagnosed using specific tests, either two-glass pre- and post-prostatic massage or the Meares-Stamey four-glass test. A retrospective study over a 5-year period (between August 1st 2006 and July 31st 2011) was performed. All patients who met the criteria for microbiological prostatitis were included and assigned to one of two groups, either a study group [paucisymptomatic infectious prostatitis (PIP)] or a control group [classic infectious prostatitis (CIP)]. Epidemiological, clinical, microbiological, and treatment-related variables were collected. A comparative study between both groups was performed. Thirty-nine patients were diagnosed with prostatitis. The main risk factors were unprotected anal intercourse, human immunodeficiency virus (HIV) infection, recent travel, and recurrent urinary tract infections. The most significant differences between the PIP (19 patients) and CIP (20 patients) groups were higher frequency of elevated inflammatory markers, higher frequency of monomicrobial etiology, and longer treatment. In monomicrobial prostatitis, the most common causative agents were coagulase-negative Staphylococcus spp., Escherichia coli, and Corynebacterium glucuronolyticum. According to the findings of this study, we believe that prostatitis should be included as a possible diagnosis in a man who complains of prolonged fever without an apparent origin and having at least one of the following risk factors: unprotected anal intercourse, HIV infection, recent travel, and recurrent urinary tract infections.
根据文献记载,前列腺炎是一种罕见的无明显病因的长期发热原因。然而,这种综合征可以通过特定的检查很容易地诊断出来,例如前列腺按摩前两杯和后两杯或 Meares-Stamey 四杯试验。进行了一项为期 5 年的回顾性研究(2006 年 8 月 1 日至 2011 年 7 月 31 日)。所有符合微生物前列腺炎标准的患者均被纳入研究,并分为两组:研究组[少症状性感染性前列腺炎(PIP)]或对照组[经典感染性前列腺炎(CIP)]。收集了流行病学、临床、微生物学和治疗相关的变量。对两组进行了比较研究。诊断为前列腺炎的患者有 39 例。主要危险因素为无保护肛交、人类免疫缺陷病毒(HIV)感染、近期旅行和反复尿路感染。PIP(19 例)和 CIP(20 例)组之间最显著的差异是炎症标志物升高的频率更高、单微生物病因的频率更高和治疗时间更长。在单微生物前列腺炎中,最常见的病原体是凝固酶阴性葡萄球菌、大肠杆菌和糖肽酶阳性棒状杆菌。根据这项研究的结果,我们认为前列腺炎应被纳入有以下至少一个危险因素的长期不明原因发热男性的可能诊断中:无保护肛交、HIV 感染、近期旅行和反复尿路感染。