Candida Prostatitis: A Review and Update

Abstract

Candidiasis is a terminology that is used for a fungal infection that is caused by a yeast which is a fungus that called candida species. Some species of candida can cause infection in human beings and the commonest candida species that can infect human beings is candida Albicans. Candida normally lives upon the skin as well as inside the human body, such as the mouth, the throat, the gut, and the vagina, without causing problems. Candida can cause infections if it grows out of control or if it enters deep into the body. For example, it could cause infections in the bloodstream or internal organs like the kidney, the heart, or the brain. Candida infection can be localized to one body organ or it could be a disseminated candida infection affecting various organs. Candida infection does tend to afflict immune-supressed individuals more often in comparison with immune competent individuals. Candida prostatitis an uncommon condition which clinicians should have a high index of suspicion for because it does manifest with non-specific symptoms that tend to be associated with more common conditions of the prostate and the urinary tract. Candida infection of the prostate gland may be an isolated de novo infection or it may be associated disseminated candida infection, or it may also be associated with prostate cancer or various immune-suppression conditions. Candida infection of the prostate gland could manifest as an acute infection/inflammation of the prostate gland or a chronic inflammation of the prostate gland or it could manifest as prostatic abscess. Some of the potential manifestations of candida prostatitis and or prostatic abscess include: (a) incidental finding upon biopsy of the prostate gland or following trans-urethral resection of prostate gland or prostatectomy. ( b) patient may manifest with lower urinary tract symptoms, (c) a patient may manifest with urinary retention that may be acute or chronic, (d) a patient may manifest with raised levels of serum prostate specific antigen (PSA), € at times when digital rectal examination is undertaken on a patient who has Candida prostatitis, the prostate gland may feel benign and in the case of a candida prostatic abscess rectal examination may demonstrate bogginess in the area of the prostate with soft fluctuant feeling. (f) Eosinophil count in some cases of Candida prostatitis would tend to be normal but in some cases of candida infection of the prostate gland, there could be Eosinophilia but this would not be diagnostic of Candida infection, (g) a history of having had coital contact with an individual who has been treated for candida infection or a history of past treatment of the individual should alert all clinicians to exclude the possibility of candida prostatitis. (h) on rare occasions urine culture or culture of expressed prostatic secretions would yield a growth of Candida. Diagnosis of Candida infection or abscess of the prostate gland may be confirmed by positive culture of Candida in prostate biopsy specimen or resected or excised prostate specimen. Treatment of Candida Prostatitis / prostatic abscess does tend to entail: (a) Treatment with appropriate antifungal medicament, plus (b) Complete radiology image-guided aspiration / drainage of any abscess seen plus / minus or endoscopic deroofing trans-urethral resection of the prostate to ensure the abscess drains out completely. Because recurrence of Candida prostatitis or prostatic abscess or Candida infection elsewhere can occur, it is important for patients to have regular follow-up assessments to ensure recurrence disease does not develop and if it develops, it is diagnosed quickly in order to initiate prompt treatment. It is also important to assess all coital contacts of the patient to ascertain if they have Candida infection to enable prompt treatment of their infection. If an individual who has candida prostatitis or prostatic abscess is also found to have contemporaneous adenocarcinoma of the prostate, the carcinoma of the prostate gland should be treated appropriately based upon the Gleason Grade and the Stage of the carcinoma, the performance status and age of the individual patient based upon the national and international guidelines pertaining to prostate cancer as a separate multi-disciplinary team discussion of the patient management.