Based on clinical and laboratory presentation, prostatitis is classified into the following categories as recommended by the United States National Institutes of Health (Table 1) (10). Acute bacterial prostatitisA small minority of men, less than 1% of all prostatitis cases, have acute bacterial prostatitis. This is an acute febrile illness, and prompt antibiotic treatment is necessary. The patient presents with symptoms of urinary tract infection (urgency and dysuria), prostate inflammation (perineal, penile, or rectal pain), and systemic infection (fever and malaise). The prostate gland is tender and enlarged on rectal examination. A swollen enlarged prostate may rarely cause obstruction of urine flow. Acute prostatitis can lead to prostatic abscess or epididymitis. A prostatic abscess is suspected when a patient fails to improve despite proper antibiotic treatment. It is estimated that in 5 to 10% of cases acute inflammation can result in chronic prostatitis (11). Chronic bacterial prostatitisChronic bacterial prostatitis accounts for 5 to 10% of all prostatitis cases. Symptoms of prostate inflammation last for more than 3 months. Patients complain of urgency, dysuria, and perineal, penile, or even lower back pain. When urine cultures obtained over the course of an illness repeatedly grow the same bacterial strain,

A laboratory-confirmed lymphogranuloma venereum (LGV) case in Slovenia was reported in 2015, in a human immunodeficiency virus (HIV)-negative man presenting with inguinal lymphadenopathy. He reported unprotected insertive anal intercourse with two male partners in Croatia. Variant L2c of Chlamydia trachomatis was detected in clinical samples. Although the patient was eventually cured, the recommended treatment regimen with doxycycline had to be prolonged.

Clinical characteristics associated with isolation of Borrelia burgdorferi sensu lato from skin have not been fully evaluated. To gain insight into predictors for a positive EM skin culture, we compared basic demographic, epidemiologic, and clinical data in 608 culture-proven and 501 culture-negative adult patients with solitary EM. A positive Borrelia spp. skin culture was associated with older age, a time interval of >2 days between tick bite and onset of the skin lesion, EM ≥5 cm in diameter, and location of the lesion on the extremities, whereas several other characteristics used as clinical case definition criteria for the diagnosis of EM (such as tick bite at the site of later EM, information on expansion of the skin lesion, central clearing) were not. A patient with a 15-cm EM lesion had almost 3-fold greater odds for a positive skin culture than patients with a 5-cm lesion. Patients with a free time interval between the tick bite and onset of EM had the same probability of a positive skin culture as those who did not recall a tick bite (OR=1.02); however, the two groups had >3-fold greater odds for EM positivity than patients who reported a tick bite with no interval between the bite and onset of the lesion. In conclusion, several yet not all clinical characteristics used in EM case definitions were associated with positive Borrelia spp. skin culture. The findings are limited to European patients with solitary EM caused predominantly by B. afzelii but may not be valid for other situations.

BackgroundHepatitis C virus (HCV) infection represents a major global health problem, which in high-income countries now mostly affects people who inject drugs (PWID). Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular.MethodsThirty-three European countries were invited to participate. Data on available national strategies, action plans and guidelines for HCV treatment in general population and in PWID specifically were collected prospectively by means of a structured electronic questionnaire and analyzed accordingly.ResultsAll of the 33 invited European countries participated in the survey. Twenty-two responses came from non-governmental organizations, six from public health institutions, four from university institutions and one was an independent consultant. Fourteen (42.4%) of the countries reported having a national strategy and/or national action plan for HCV treatment, from which ten of them also reported having a national strategy and/or national action plan for treatment of HCV infection in PWID. Nearly three-quarters reported having national HCV treatment guidelines. PWID were included in the majority (66.7%) of the guidelines. Fourteen (42.4%) countries reported having separate guidelines for the treatment of HCV infection in PWID.ConclusionsGiven the high burden of HCV-related morbidity and mortality in PWID in Europe, the management of HCV infection should become a healthcare priority in all European countries, starting with developing or using already-existing national strategies, action plans and guidelines for this population.

Elderly patients from NHs admitted to hospital for bacterial infection are older and more debilitated than their counterparts from the community. Microorganisms found in the NH residents are somewhat different from those in the community dwellers. The community dwellers had a better survival rate than those admitted from the NHs after adjusting for age, sex, presence of any comorbidity, and debility.