臨床泌尿器科66巻11号

2012年10月発行

特集 古くて新しい前立腺炎の臨床

急性細菌性前立腺炎の診断と対応

著者： 矢澤聰¹ 金尾健人¹ 本郷周¹ 大家基嗣¹

所属機関： ¹慶應義塾大学医学部泌尿器科学教室

ページ範囲：P.817 - P.822

要旨　急性細菌性前立腺炎の主な起因菌はグラム陰性桿菌，中でもE. Coliが大半を占め，淋菌，クラミジアは稀である。急性発症の局所症状（膀胱刺激症状，排尿困難感，頻尿，尿意切迫感など）と全身症状（倦怠感，嘔気・嘔吐，悪寒・戦慄など）を呈し，尿検査で白血球尿，細菌尿を認め，直腸診で圧痛，熱感，腫脹を認めることが多い。経直腸的前立腺超音波検査は前立腺膿瘍の除外に有用である。一方，前立腺マッサージは敗血症を惹起することがあるので禁忌である。経直腸的前立腺生検後の急性細菌性前立腺炎は，自然発生の群と比較して高齢で，前立腺体積が大きく，治療抵抗例が多いので注意が必要である。

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