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Prostate Infection or Not?
54 y/o male with a hx of chronic bacterial prostatitis ... confirmed several times upon prostatic fluid culture. My PSA just jumped from 1.6 to 2.3 over the past 12 months. On that same day that the blood was drawn for the PSA, urinalysis indicated "Small" leukocyte esterase and 5-10 WBC. Prostatic Fluid culture taken 2 weeks later pending.
Obviously, if the culture is positive, we know what to do - treat with suitable antibiotic. Question is ... what to do if culture is negative? Could this have been a "measurable" infection at the time of the PSA draw/urinalysis that was no longer significant enough to be measurable two weeks later when the culture sample was taken? Do we go straight to biopsy if the culture is negative, given the obvious concern over PSA velocity?
Thanks for your help.
Obviously, if the culture is positive, we know what to do - treat with suitable antibiotic. Question is ... what to do if culture is negative? Could this have been a "measurable" infection at the time of the PSA draw/urinalysis that was no longer significant enough to be measurable two weeks later when the culture sample was taken? Do we go straight to biopsy if the culture is negative, given the obvious concern over PSA velocity?
Thanks for your help.
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