Two
years ago, he married with his girlfriend, a victim of monilial
vaginitis, which he didn’t know. He engaged in an unprotected
intercourse with his wife. But three weeks later, he began to experience
urinary retention and was catheterized with 400 mL of residual urine.
He was placed on tamsulosin and did well.
However,
after one week, while on a business trip, the patient began to
experience dysuria and started taking levofloxacin. He continued to have
symptoms and reported back to his urologist. Urinalysis while on
antibiotics showed 20-30 white cells and 20-30 red blood cells per high
power field, but cultures were negative. He was asked to continue his
antibiotics. One week later, he again had urinary retention and
underwent catheterization with 450 ml residual. His tamsulosin was
increased and levofloxacin was continued. A second urine culture,
without urinalysis, was performed 3 days later, which was again sterile.
Symptoms never completely resolved. At no time did the patient
experience systemic symptoms, such as fevers or chills.
After
1 month of antibiotics, his dysuria progressed to perineal discomfort
and burning after urination. At that time, he was seen once again by
urology. Urinalysis again showed 20-30 white blood cells and 20-30 red
blood cells per high power field, and rectal examination revealed a
slightly boggy prostate with mild tenderness. Urine culture, prostate
secretion cultures, and ejaculate cultures all grew candida albicans at
that time.
As a matter of fact, he was diagnosed at that time with candida prostatitis.
He was started on fluconazole 400 mg daily for 6 weeks, with total
resolution of symptoms after the first week of therapy. He is currently
symptom-free over a year later, and follow-up urinalysis after treatment
returned to normal.
Fluconazole is an antifungal
medication, which was developed by scientists at Pfizer and was first
marketed in 1990. It is now available as the common treat for prostatitis candida.
It is used to treat a variety of fungal infections, especially candida
infections, mouth, throat, and bloodstream. What's more, it can prevent
infections in people with weak immune systems, including those with
neutropenia due to cancer chemotherapy, transplant patients, and
premature babies.
Since fluconazole therapy has
been associated with QT interval prolongation, which may lead to serious
cardiac arrhythmias. Thus, it is used with caution in patients with
risk factors for prolonged QT interval, such as electrolyte imbalance or
use of other drugs that may prolong the QT interval. Therefore, Dr. Lee
currently suggests the best treatment for prostatitis candida--herbal
medicine. Made of natural herbs, herbal medicines have other advantages
like no drug resistance, good at treating chronic disease with no
side-effects. Especially the herbal pill called diuretic and
anti-inflammatory pill is strongly recommended. It has been clinically
proved that diuretic and anti-inflammatory pill
can shorten the course of treatment, relieving the torture of frequent
urge to urinate, pain or burning during urination because it can work on
lesion area directly with the effect of eliminating inflammation,
activating blood and removing toxin.
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