Skip to main content

Advertisement

SpringerLink
Log in

How to diagnose and treat fungal infections in chronic prostatitis

  • Published:
Current Urology Reports Aims and scope Submit manuscript

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 immunecompetent 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Marr KA: Invasive Candida infections: the changing epidemiology. Oncology (Huntingt) 2004, 18:9–14. This article provides insight into the causes of changing patterns of candidal infection.

    Google Scholar 

  2. Morris BS, Chudgar PD, Manejwala O: Primary renal candidiasis: fungal mycetomas in the kidney. Australas Radiol 2002, 46:57–59.

    Article  PubMed  Google Scholar 

  3. Bell DA, Rose SC, Starr NK, et al.: Percutaneous nephrostomy for nonoperative management of fungal urinary tract infections. J Vasc Interv Radiol 1993, 4:311–315.

    PubMed  CAS  Google Scholar 

  4. Jacobs LG, Skidmore EA, Freeman K, et al.: Oral fluconazole compared with bladder irrigation with amphotericin B for treatment of fungal urinary tract infections in elderly patients. Clin Infect Dis 1996, 22:30–35.

    PubMed  CAS  Google Scholar 

  5. Bartkowski DP, Lanesky JR: Emphysematous prostatitis and cystitis secondary to Candida albicans. J Urol 1988, 139:1063–1065.

    PubMed  CAS  Google Scholar 

  6. Yu S, Provet J: Prostatic abscess due to Candida tropicalis in a nonacquired immunodeficiency syndrome patient. J Urol 1992, 148:1536–1538.

    PubMed  CAS  Google Scholar 

  7. Lentino JR, Zielinski A, Stachowski M, et al.: Prostatic abscess due to Candida albicans. J Infect Dis 1984, 149:282.

    PubMed  CAS  Google Scholar 

  8. Elert A, von Knobloch R, Nusser R, et al.: Isolated candidal prostatitis. J Urol 2000, 163:244.

    Article  PubMed  CAS  Google Scholar 

  9. Williamson MR, Smith AY, Black WC, Rosenberg RD:Diagnosis of candidal infection of the prostate by transrectal ultrasonography and biopsy. J Clin Ultrasound 1992, 20:618–620.

    Article  PubMed  CAS  Google Scholar 

  10. Indudhara R, Singh SK, Vaidyanathan S, Banerjee CK:Isolated invasive candidal prostatitis. Urol Int 1992, 48:362–364.

    PubMed  CAS  Google Scholar 

  11. Frye KR, Donovan JM, Drach GW: Torulopsis glabrata urinary infections: a review. J Urol 1988, 139:1245–1249.

    PubMed  CAS  Google Scholar 

  12. Kauffman CA, Tan JS: Torulopsis glabrata renal infection. Am J Med 1974, 57:217–224.

    Article  PubMed  CAS  Google Scholar 

  13. Haas CA, Bodner DR, Hampel N, Resnick MI: Systemic candidiasis presenting with prostatic abscess. Br J Urol 1998, 82:450–451.

    PubMed  CAS  Google Scholar 

  14. Horowitz BJ, Edelstein SW, Lippman L: Sexual transmission of Candida. Obstet Gynecol 1987, 69:883–886.

    PubMed  CAS  Google Scholar 

  15. Abbas F, Kamal MK, Talati J: Prostatic aspergillosis. J Urol 1995, 153:748–750.

    Article  PubMed  CAS  Google Scholar 

  16. Hood SV, Bell D, McVey R, et al.: Prostatitis and epididymoorchitis due to Aspergillus fumigatus in a patient with AIDS. Clin Infect Dis 1998, 26:229–231.

    Article  PubMed  CAS  Google Scholar 

  17. Kaplan-Pavlovcic S, Masera A, Ovcak Z, Kmetec A: Prostatic aspergillosis in a renal transplant recipient. Nephrol Dial Transplant 1999, 14:1778–1780.

    Article  PubMed  CAS  Google Scholar 

  18. Zaas AK, Alexander BD: Echinocandins: role in antifungal therapy, 2005. Expert Opin Pharmacother 2005, 6:1657–1668.

    Article  PubMed  CAS  Google Scholar 

  19. Siddiqui T, Zamani T, Parada JP: Primary cryptococcal prostatitis and correlation with serum prostate-specific antigen in a renal transplant recipient. J Infect 2005, 5:e153-e157. This paper cites an interesting case report and literature review of interesting cases.

    Article  Google Scholar 

  20. Hinchey WW, Someren A: Cryptococcal prostatitis. Am J Clin Pathol 1981, 75:257–260.

    PubMed  CAS  Google Scholar 

  21. King C, Finley R, Chapman SW: Prostatic cryptococcal infection. Ann Intern Med 1990, 113:720.

    PubMed  CAS  Google Scholar 

  22. Larsen RA, Bozzette S, McCutchan JA, et al.: Persistent Cryptococcus neoformans infection of the prostate after successful treatment of meningitis. California Collaborative Treatment Group. Ann Intern Med 1989, 111:125–128.

    PubMed  CAS  Google Scholar 

  23. Adams JR Jr, Mata JA, Culkin DJ, et al.: Acquired immunodeficiency syndrome manifesting as prostate nodule secondary to cryptococcal infection. Urology 1992, 39:289–291.

    Article  PubMed  Google Scholar 

  24. Milchgrub S, Visconti E, Avellini J: Granulomatous prostatitis induced by capsule-deficient cryptococcal infection. J Urol 1990, 143:365–366.

    PubMed  CAS  Google Scholar 

  25. Fuse H, Ohkawa M, Yamaguchi K, et al.: Cryptococcal prostatitis in a patient with Behcet’s disease treated with fluconazole. Mycopathologia 1995, 130:147–150.

    Article  PubMed  CAS  Google Scholar 

  26. Yip SK, Cheng C, Wong MY, et al.: Cryptococcal prostatic abscess in an immunocompromised patient: a case report and review of the literature. Ann Acad Med Singapore 1998, 27:873–876.

    PubMed  CAS  Google Scholar 

  27. Sax PE: Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 7, 1994: a 55-yearold heart transplant recipient with a tender, enlarged prostate gland. N Engl J Med 1994, 330:490–496.

    Article  Google Scholar 

  28. Allen R, Barter CE, Chachoua LL, et al.: Disseminated cryptococcosis after transurethral resection of the prostate. Aust N Z J Med 1982, 12:296–299.

    PubMed  CAS  Google Scholar 

  29. Perfect JR, Casadevall A: Cryptococcosis. Infect Dis Clin North Am 2002, 16:837–874.

    Article  PubMed  Google Scholar 

  30. Bozzette SA, Larsen RA, Chiu J, et al.: Fluconazole treatment of persistent Cryptococcus neoformans prostatic infection in AIDS. Ann Intern Med 1991, 115:285–286.

    PubMed  CAS  Google Scholar 

  31. Malin JM Jr, Anderson EE, Weber CH: North American blastomycosis of the urogenital tract. J Urol 1969, 102:754–757.

    PubMed  Google Scholar 

  32. Eickenberg HU, Amin M, Lich R Jr: Blastomycosis of the genitourinary tract. J Urol 1975, 113:650–652.

    Google Scholar 

  33. Inoshita T, Youngberg GA, Boelen LJ, Langston J: Blastomycosis presenting with prostatic involvement: report of 2 cases and review of the literature. J Urol 1983, 130:160–162.

    PubMed  CAS  Google Scholar 

  34. Seo R, Oyasu R, Schaeffer A: Blastomycosis of the epididymis and prostate. Urology 1997, 50:980–982.

    Article  PubMed  CAS  Google Scholar 

  35. Bergner DM, Kraus SD, Duck GB, Lewis R: Systemic blastomycosis presenting with acute prostatic abscess. J Urol 1981, 126:132–133.

    PubMed  CAS  Google Scholar 

  36. Craig MW, Davey WN, Green RA: Conjugal blastomycosis. Am Rev Respir Dis 1970, 102:86–90.

    PubMed  CAS  Google Scholar 

  37. Pappas PG: Blastomycosis. Semin Respir Crit Care Med 2004, 25:113–121. An excellent review of blastomycosis.

    Article  PubMed  Google Scholar 

  38. Park BJ, Sigel K, Vaz V, et al.: An epidemic of coccidioidomycosis in Arizona associated with climatic changes, 1998–2001. J Infect Dis 2005, 191:1981–1987.

    Article  PubMed  Google Scholar 

  39. Kuntze JR, Herman MH, Evans SG: Genitourinary coccidioidomycosis. J Urol 1988, 140:370–374.

    PubMed  CAS  Google Scholar 

  40. Stevens DA: Coccidioidomycosis. N Engl J Med 1995, 332:1077–1082.

    Article  PubMed  CAS  Google Scholar 

  41. Abrams DI, Robia M, Blumenfeld W, et al.: Disseminated coccidioidomycosis in AIDS. N Engl J Med 1984, 310:986–987.

    Article  PubMed  CAS  Google Scholar 

  42. Einstein HE, Johnson RH: Coccidioidomycosis: new aspects of epidemiology and therapy. Clin Infect Dis 1993, 16:349–354.

    PubMed  CAS  Google Scholar 

  43. Niku SD, Dalgleish G, Devendra G: Coccidioidomycosis of the prostate gland. Urology 1998, 52:127.

    Article  PubMed  CAS  Google Scholar 

  44. Lawrence MA, Ginsberg D, Stein JP, et al.: Coccidioidomycosis prostatitis associated with prostate cancer. BJU Int 1999, 84:372–373.

    Article  PubMed  CAS  Google Scholar 

  45. Sung JP, Sun SS, Crutchlow PF: Coccidioidomycosis of the prostate gland and its therapy. J Urol 1979, 121:127–128.

    PubMed  CAS  Google Scholar 

  46. Sohail MR, Andrews PE, Blair JE: Coccidioidomycosis of the male genital tract. J Urol 2005, 173:1978–1982. An excellent review of male genital coccidioidomycosis.

    Article  PubMed  Google Scholar 

  47. Yurkanin JP, Ahmann F, Dalkin BL: Coccidioidomycosis of the prostate: a determination of incidence, report of 4 cases, and treatment recommendations. J Infect 2006,52:e19-e25. An excellent study of the epidemiology, diagnosis, and treatment of prostatic coccidioidomycosis.

    Article  PubMed  Google Scholar 

  48. Bradsher RW: Histoplasmosis and blastomycosis. Clin Infect Dis 1996, 22(suppl 2):S102-S111.

    PubMed  Google Scholar 

  49. Mawhorter SD, Curley GV, Kursh ED, Farver CE: Prostatic and central nervous system histoplasmosis in an immunocompetent host: case report and review of the prostatic histoplasmosis literature. Clin Infect Dis 2000, 30:595–598.

    Article  PubMed  CAS  Google Scholar 

  50. Andersen TC, Jurgensen GW, Christensen E: Lycopodium spores in transrectal ultrasound-guided core biopsies of the prostate. Scand J Urol Nephrol 1998, 32:148–149.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Maimonides Medical Center, 48-02 10th Avenue, 11219, Brooklyn, NY, USA

    Gilbert J. Wise MD

Authors
  1. Gilbert J. Wise MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alex Shteynshlyuger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gilbert J. Wise MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wise, G.J., Shteynshlyuger, A. How to diagnose and treat fungal infections in chronic prostatitis. Curr Urol Rep 7, 320–328 (2006). https://doi.org/10.1007/s11934-996-0012-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-996-0012-2

Keywords

Search

Navigation