Abstract
Atypical infections of the prostate are infrequently recognized or cultured. However, clinical evidence points to their occult role in the pathogenesis of prostatitis. Atypical infections of the prostate can be caused by gram-positive and gram-negative bacteria, Mycoplasma, Chlamydia, fungi and Mycobacterium tuberculosis that are not classically associated with prostatitis. Increasing evidence suggests that viruses, protozoans, and various zoonoses also play an important role in prostatic infections. Bacterial 16S ribosomal DNA found in patients with chronic prostatitis suggests a bacterial inflammatory event that initiates an autoimmune process. Prostatitis may also cause elevated levels of prostate-specific antigen, a prostate cancer tumor marker. Hence, determination of an underlying infection becomes important in the evaluation of a patient with an abnormal prostate-specific antigen level. Awareness of atypical causes of infectious prostatitis improves understanding of challenges related to the diagnosis and treatment of patients with chronic prostatitis.
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