HORCAJADA JP, MORENO-MARTINEZ A, VILANA R, MARTINEZ JA, MENSA J, VILA JW, ALMELA M, SORIANO E; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 664 (abstract no. 608).
Hosp. Clin., Barcelona, SPAIN.
BACKGROUND: To study the diagnostic yield of transrectal prostatic echography (TPE) in males with febrile urinary tract infection (UTI) and its prognostic value in acute prostatitis (AP).METHODS: From February 1996 to December 1998 males with fever and positive urine culture were enrolled. AP was diagnosed when rectal exam showed a tender prostate and acute pyelonephritis when patients had flank pain. If these physical data were absent and serum prostate-specific antigen (PSA) levels were > 10 ng/ml then AP was diagnosed. Blood leukocyte count, serum creatinine, serum C-reactive protein (CRP), serum PSA, blood cultures and a TPE were performed at inclusion. TPE was considered suggestive of AP when there were hypoechogenic or hyperechogenic lesions at the prostatic peripheral lobules. Prostatic calcifications were also analyzed.RESULTS: Seventy-five patients were included: of them, 26 (34.6%) had echographic signs of AP and 49 (65.3%) had not. Prostatic abscesses were not detected. Both groups were similar in terms of dysuria, flank pain, rectal exam and serum PSA levels. Sensitivity, specificity, positive predictive value and negative predictive value of TPE for the diagnosis of AP were 47% (21/45), 83% (24/29), 81% (21/26) and 50% (24/48), respectively. Among 45 patients with AP, 21 (47%) had echographic signs of AP and 24 (53%) had not. Age, pre-existing prostatic syndrome, length of fever before diagnosis, hospital stay, blood leukocyte count, creatinine, PSA levels, CRP values, positive blood cultures, length of fever and urinary syndrome after beginning of treatment and isolated microorganisms were not significantly different in both groups. Prostatic calcifications in AP patients, 19(42%), were not associated with any clinical or biological parameter. Blood cultures were positive in 6/19 (33%) patients with prostatic calcifications and in 2/26 (7%) patients without them (p=0.06).CONCLUSIONS: TPE has a low diagnostic value for AP in males with febrile UTI. TPE findings have no relation with the etiology, severity and clinical outcome of AP.
Publication Types:
Keywords:
- Alkaline Phosphatase
- Calcification, Physiologic
- Fever
- Flank Pain
- Humans
- Male
- Prostate
- Prostate-Specific Antigen
- Prostatic Diseases
- Prostatitis
- Pyelonephritis
- Sensitivity and Specificity
- Urinary Tract Infections
- blood
- diagnosis
- immunology
- ultrasonography
Other ID:
UI: 102246408
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