How to diagnose and treat fungal infections in chronic prostatitis |
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Authors: | Gilbert J Wise Alex Shteynshlyuger |
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Institution: | (1) Division of Urology, Maimonides Medical Center, 48-02 10th Avenue, Brooklyn, NY 11219, USA |
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Abstract: | Epidemiologic changes that include immune-compromised patients and drug-resistant fungi have caused an increase in nosocomial
infections by Candida albicans and non-albicans Candida species. Other fungi, aspergilla and Cryptococcus (environmental contaminants), are opportunistic invaders of the immune-compromised (transplant, HIV) patients. The environmental
fungi Coccidioides immitis (dry arid areas), Histoplasma capsulatum (Avian-infested areas), and Blastomyces dermatitidis (aquatic areas) can cause infections in immune-competent and immune-deficient patients. Each fungus can cause changes in
the prostate that mimic bacterial infection, benign prostatic hypertrophy, or neoplasm. Diagnosis can be established by urine
cultures or needle biopsy of the prostate. Prostate surgery for carcinoma or benign enlargement may detect latent fungal infection.
Different fungal species can have divergent clinical manifestations and require different treatment. In some cases, asymptomatic,
localized, fungal prostatitis can be cured by removal of the infected gland. Symptomatic and disseminated infection may require
prostatectomy and systemic antifungal therapy. |
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