Semen! Need help

BCapstone bcapstone at aol.com
Fri Sep 30 19:56:01 EST 1994


In article <Pine.3.89.9409301533.A11744-0100000 at isnet.is.wfu.edu>,
bmorrell at ISNET.IS.WFU.EDU ("Robert Morrell Jr.") writes:

<<<<<<Having explored this case both in am off list thread with the
original 
poster and on list postings, I must conclude that there is a 
contradiction in this list's approach.  The patient had E. cloacae in his
blood. No source of the infection was found.  The patient has what appears
to be rods in his semen, but it stains poorly 
and does not grow on culture. The contradiction is that many, including
myself initially, looked for
some fastidious or unknown organism, when the question that the original
poster has is could it be the E. cloacae that infected the blood? I say
that it could not be. E. cloacae is a standard enteric, easy to grow on
routine media. Bacterial prostatitis cases routinely recover enterics
from culture, so clearly there is nothing in the prostate environment that
 ntrinsically prevents recovery of the organism.>>>>

The prostatic fluid contain spermicin, spermidine, and zinc, all of which
are thought to be natural antibiotics and may explain no growth.

<<<<< This is a classic case of non-bacterial prostatitis, and therefore
one would not suspect E.
cloacae, and therefore it is probably not the source of the sepsis.>>>>>

Definitely is not a classic case of non-bacterial prostatitis.  Patient
has achieved clinical cures with antibiotic therapy in the past.  Present
course of symptoms of bacteremia, followed by documented case of sepsis
during acute prostatitis are not consistent with "non-bacterial
prostatitis" which may be a misnomer.  Furthermore the patient has 60
wbc's per high powered field in the EPS, which is much higher than in the
classical "non-bacterial prostatitis case."  Furthermore unculturable
bacteria are seen in the semen.

<<<<Divorced from the blood culture, this case becomes just another in a
long 
series of frustrations in identifying the pathogens involved in
non-bacterial prostatitis. Interesting perhaps, but not a new
problem.>>>>>>

I not sure that there is such a long series of frustrations.  It is my
understanding that the etiolgic agent of Whipples Disease, whipples
bacillus, was found by PCR.  That Bartonella was found to be the etiolgic
agent in Cat-scratch disease and the PCR helped to sort out the roles of
Bartonella and Afpia.  Lastly, the role of H. Pylori in ulcer disease
would have to considered another example of finding the etiologic agent
where one was suspected but difficult to diagnose.  J.C. Nickel has
proposed that a better name for some forms of prostatits would be
"antibiotic-resistant chronic bacterial prostatitis," and I suspect that
this nomenclature should replace "non-bacterial prostatitis" in most
cases.



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