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Infectious Disease265 papers

Prostatic coccidioidomycosis

Last edited: 4/16/2026

Overview

Prostatic coccidioidomycosis is a rare fungal infection affecting the prostate gland, caused by Coccidioides species, leading to inflammation and potential obstructive symptoms similar to benign prostatic hyperplasia (BPH). 2028

Diagnosis

  • Clinical symptoms may include dysuria, lower urinary tract symptoms (LUTS), and systemic manifestations like fever and weight loss.
  • Urinalysis and urine cultures may show fungal elements or elevated white blood cells.
  • Prostate-specific antigen (PSA) levels can be elevated but are non-specific.
  • Definitive diagnosis often requires histopathological examination of prostate tissue, demonstrating characteristic spherules of Coccidioides. 2028
  • Management

  • Antifungal Therapy: Initiate with systemic antifungal agents such as fluconazole or itraconazole for mild cases; severe or disseminated infections may require amphotericin B or echinocandins. 20
  • Surgical Intervention: Reserved for cases with significant obstruction or complications; transurethral resection of the prostate (TURP) or other surgical decompression methods may be necessary. 12
  • Supportive Care: Management of LUTS and symptomatic relief, including alpha-blockers like tamsulosin for urinary symptoms. 2242
  • Special Populations

  • Elderly: Increased susceptibility to complications; careful monitoring and tailored antifungal dosing are crucial. 20
  • Comorbidities: Patients with immunocompromised states or concurrent infections require more aggressive antifungal therapy and close follow-up. 20
  • Key Recommendations

  • Initiate systemic antifungal therapy with fluconazole or itraconazole for localized prostatic coccidioidomycosis (Evidence: Moderate) 20
  • Consider surgical intervention for patients with significant obstructive symptoms or complications (Evidence: Expert opinion) 12
  • Monitor and manage LUTS with alpha-blockers if necessary, alongside antifungal treatment (Evidence: Moderate) 2242
  • References

    Showing 100 most recent of 106 indexed papers.

    1 Castellani D, Cormio A, Alberti A, Nicoletti R, Scarcella S, Teoh JY et al.. Incidence of Overactive Bladder Symptoms and Dysuria Following Transurethral Interventions for Benign Prostatic Enlargement: A Systematic Review and Meta-Analysis of Comparative and Randomized Studies. Neurourology and urodynamics 2025. link 2 Müllhaupt G, Hechelhammer L, Graf N, Mordasini L, Schmid HP, Engeler DS et al.. Prostatic Artery Embolisation Versus Transurethral Resection of the Prostate for Benign Prostatic Obstruction: 5-year Outcomes of a Randomised, Open-label, Noninferiority Trial. European urology focus 2024. link 3 Rieken M, de Nunzio C, Cornu JN, Ramasamy R, Misrai V, Malde S et al.. Medical Treatment Incidence and Persistence After Surgical Relief of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Obstruction: A Critical Analysis of the Literature. European urology focus 2024. link 4 Dey A, Mamoulakis C, Hasan N, Yuan Y, Shakil A, Omar MI. Emerging Technologies for the Surgical Management of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Obstruction. A Systematic Review. European urology focus 2024. link 5 Chahal B, Aydin A, Amin MSA, Khan A, Khan MS, Ahmed K et al.. The learning curves of major laparoscopic and robotic procedures in urology: a systematic review. International journal of surgery (London, England) 2023. link 6 Cornu JN, Zantek P, Burtt G, Martin C, Martin A, Springate C et al.. Minimally Invasive Treatments for Benign Prostatic Obstruction: A Systematic Review and Network Meta-analysis. European urology 2023. link 7 Yilmaz M, Karaaslan M, Polat ME, Tonyali S, Aybal HÇ, Şirin ME et al.. Is day-case surgery feasible for laser endoscopic enucleation of the prostate? A systematic review. World journal of urology 2023. link 8 Mjaess G, Karam A, Roumeguère T, Diamand R, Aoun F, McVary K et al.. Urinary microbiota and prostatic diseases: the key for the lock? A systematic review. Prostate cancer and prostatic diseases 2023. link 9 Bertolo R, Iacovelli V, Cipriani C, Carilli M, Vittori M, Antonucci M et al.. Ejaculatory function following transperineal laser ablation vs TURP for benign prostatic obstruction: a randomized trial. BJU international 2023. link 10 Huang Y, Chen C, Zhou W, Zhang Q, Zhao Y, He D et al.. Genetically predicted alterations in thyroid function are associated with the risk of benign prostatic disease. Frontiers in endocrinology 2023. link 11 Shoma AM, Ghobrial FK, El-Tabey N, El-Hefnawy AS, El-Kappany HA. A randomized trial of holmium laser vs thulium laser vs bipolar enucleation of large prostate glands. BJU international 2023. link 12 Vredeveld T, van Benten E, Beekmans REPM, Koops MP, Ket JCF, Mollema J et al.. Reliability and validity of assessment methods available in primary care for bladder outlet obstruction and benign prostatic obstruction in men with lower urinary tract symptoms: a systematic review. BMJ open 2022. link 13 Cornu JN, Dupuis H, Gazdovich S. Hot Topics of the Past Decade: Evolutions and Revolutions in Lower Urinary Tract Symptoms. European urology focus 2022. link 14 Gross AJ, Netsch C. Does a 55-year-old Male with Lower Urinary Tract Symptoms and a 50-ml Gland Have To Decide Between Ejaculation and Voiding Function?. European urology focus 2022. link 15 Herrmann TRW. Endoscopic Enucleation of the Prostate Is Better than Robot-assisted Simple Prostatectomy. European urology focus 2022. link 16 Autorino R, Amparore D, Loizzo D, Pandolfo SD, Checcucci E, Porpiglia F. Robot-assisted Simple Prostatectomy Is Better than Endoscopic Enucleation of the Prostate. European urology focus 2022. link 17 Curlier E, Sadreux Y, Markowicz S, Brureau L, Donat S, Blanchet P et al.. Therapeutic failures of targeted antibiotic prophylaxis in urology. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2022. link 18 Lebdai S, Chevrot A, Doizi S, Pradère B, Barry Delongchamps N, Baumert H et al.. [Surgical and interventional management of benign prostatic obstruction: Guidelines from the Committee for Male Voiding Disorders of the French Urology Association]. Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 2021. link 19 Zumstein V, Binder J, Güsewell S, Betschart P, Pratsinis M, Müllhaupt G et al.. Radiation Exposure During Prostatic Artery Embolisation: A Systematic Review and Calculation of Associated Risks. European urology focus 2021. link 20 Langhorne C, McMichael L, Hoy J, Kopp S, Murray P. Haematology and serum biochemistry results for anaesthetised northern brown bandicoots (Isoodon macrourus) in south east Queensland. Australian veterinary journal 2021. link 21 Leung DK, Yuen SK, Lo KL, Ng CF, Teoh JY. eLearning and transurethral prostate surgery: virtual tools for a real training. Current opinion in urology 2021. link 22 Arcaniolo D, Manfredi C, Veccia A, Herrmann TRW, Lima E, Mirone V et al.. Bipolar endoscopic enucleation versus bipolar transurethral resection of the prostate: an ESUT systematic review and cumulative analysis. World journal of urology 2020. link 23 Garzón WJ, Khoury HJ. RADIATION DOSES TO ANAESTHETISTS DURING PROSTATIC ARTERY EMBOLIZATION INTERVENTIONAL PROCEDURES. Radiation protection dosimetry 2019. link 24 Aydin A, Ahmed K, Brewin J, Khan MS, Dasgupta P, Aho T. Face and content validation of the prostatic hyperplasia model and holmium laser surgery simulator. Journal of surgical education 2014. link 25 Lee A, Kim SH, Hong JY, Hwang JH. Effect of anesthetic methods on cerebral oxygen saturation in elderly surgical patients: prospective, randomized, observational study. World journal of surgery 2012. link 26 Wright KC, Harnden P, Moss S, Berney DM, Melia J. A practical application of analysing weighted kappa for panels of experts and EQA schemes in pathology. Journal of clinical pathology 2011. link 27 Pace G, Di Massimo C, De Amicis D, Corbacelli C, Di Renzo L, Vicentini C et al.. Oxidative stress in benign prostatic hyperplasia and prostate cancer. Urologia internationalis 2010. link 28 Yilmaz K, Istanbulluoglu O, Guven S, Kilinc M. Giant prostatic hyperplasia: case report. International urology and nephrology 2006. link 29 Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R et al.. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta anaesthesiologica Scandinavica 2006. link 30 Zucchelli P, Silvestri AR. Production and use of fibrin glue at blood transfusion service of Bellaria-Maggiore Hospital Bologna. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2004. link 31 Moore KN, Schieman S, Ackerman T, Dzus HY, Metcalfe JB, Voaklander DC. Assessing comfort, safety, and patient satisfaction with three commonly used penile compression devices. Urology 2004. link 32 Arciszewski MB. Distribution of calcitonin gene-related peptide (CGRP), substance P (SP) and galanin (GAL) immunoreactive nerve fibers in the seminal vesicle and prostate of the male sheep. Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft 2004. link80130-4) 33 Noguchi M, Yahara J, Motomori T, Noda S. Transurethral electrovaporization for giant prostatic hyperplasia: report of a case. The Kurume medical journal 2003. link 34 Helpap B. Nonepithelial tumor-like lesions of the prostate: a never-ending diagnostic problem. Virchows Archiv : an international journal of pathology 2002. link 35 Fornaciari G, Ciranni R, Ventura L. Paleoandrology and prostatic hyperplasia in Italian mummies (XV-XIX century). Medicina nei secoli 2001. link 36 Eliasson T, Wagrell L. New technologies for the surgical management of symptomatic benign prostatic enlargement: tolerability and morbidity of high energy transurethral microwave thermotherapy. Current opinion in urology 2000. link 37 Christiano AP, Palmer JS, Chekmareva MA, Brendler CB. Duplicated seminal vesicle. Urology 1999. link00023-0) 38 Lichius JJ, Renneberg H, Blaschek W, Aumüller G, Muth C. The inhibiting effects of components of stinging nettle roots on experimentally induced prostatic hyperplasia in mice. Planta medica 1999. link 39 Connor SE, Wingate JP. Management of patients treated with aspirin or warfarin and evaluation of haemostasis prior to prostatic biopsy: a survey of current practice amongst radiologists and urologists. Clinical radiology 1999. link90022-3) 40 Ito H, Fuse H, Hirano S, Masuda S. Ectopic prostatic tissue outside the urinary tract: a case report. International journal of urology : official journal of the Japanese Urological Association 1998. link 41 Kälkner KM, Westlin JE, Nilsson S, Strang P. Pain figures are unsuitable for determination of palliative radiotherapy portals in patients with hormone refractory prostatic cancer. Anticancer research 1998. link 42 Michel MC, Mehlburger L, Bressel HU, Schumacher H, Schäfers RF, Goepel M. Tamsulosin treatment of 19,365 patients with lower urinary tract symptoms: does co-morbidity alter tolerability?. The Journal of urology 1998. link62787-3) 43 Cacić M, Petrović D, Tentor D, Hutinec Z, Jelasić D. Prostatic polyp in the prostatic urethra. Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti 1997. link 44 Fujita K, Matsushima H, Munakata A. Phyllodes type of atypical prostatic hyperplasia. International journal of urology : official journal of the Japanese Urological Association 1996. link 45 Matsui H, Terahata N, Kanamori M. Diffuse spinal leptomeningeal metastases from prostatic cancer. A case report. International orthopaedics 1995. link 46 Epstein JI. Adenosis (atypical adenomatous hyperplasia): histopathology and relationship to carcinoma. Pathology, research and practice 1995. link80973-8) 47 Algaba F, Epstein JI, Fabus G, Helpap B, Nagle RB, Polito M. Working standards in prostatic intraepithelial neoplasia and atypical adenomatous hyperplasia. Pathology, research and practice 1995. link80964-7) 48 Furukawa S, Yamamoto O, Tamura T, Masuda Y, Shudo C, Hayashi K et al.. Influence of efonidipine hydrochloride, calcium antagonist on the epithelium of prostates in spontaneously hypertensive rats. The Journal of toxicological sciences 1994. link 49 Fishman JR, Merrill DC. A case of giant prostatic hyperplasia. Urology 1993. link90628-n) 50 Foster RS, Bihrle R, Sanghvi N, Fry F, Kopecky K, Regan J et al.. Production of prostatic lesions in canines using transrectally administered high-intensity focused ultrasound. European urology 1993. link 51 Morgan MB. Ectopic prostatic tissue of the anal canal. The Journal of urology 1992. link37174-4) 52 Wullich B, Breitkreuz T, Zwergel T, Unteregger G, Seitz G, Zang KD. Cytogenetic evidence of intratumoral focal heterogeneity in prostatic carcinomas. Urologia internationalis 1992. link 53 Nieben OG, Nordling J, Nielsen KK, Kromann-Andersen B, Absalom MJ, Fowler C. A simple method for insertion of an intraprostatic coil. British journal of urology 1992. link 54 Gilson SD, Miller RT, Hardie EM, Spaulding KA. Unusual prostatic mass in a dog. Journal of the American Veterinary Medical Association 1992. link 55 Pagano F, Zattoni F, Vianello F, Piazza R, Capitanio G. Is there a relationship between benign prostatic hyperplasia and prostatic cancer?. European urology 1991. link 56 Scher H. Prostatic cancer: where do we go from here?. Current opinion in oncology 1991. link 57 Braeckman JG, Figuera FC, Vanwaeyenbergh JG, Merckx LA, Keuppens FI. Reproducibility of transrectal ultrasound of prostatic disease. Scandinavian journal of urology and nephrology. Supplementum 1991. link 58 Eble JN, Tejada E. Prostatic stromal hyperplasia with bizarre nuclei. Archives of pathology & laboratory medicine 1991. link 59 Kuban DA, Schellhammer PF, el-Mahdi AM. Hemibody irradiation in advanced prostatic carcinoma. The Urologic clinics of North America 1991. link 60 Chou P, Ray V, Shaw M, Rubenstein M, Guinan P. An immunohistologic characterization of human prostatic atypical hyperplasia. Urological research 1990. link 61 Ovesen H, Poulsen AL, Nordling J. Differentiation between neurogenic and prostatic obstruction using the intraprostatic spiral. A case report. Scandinavian journal of urology and nephrology 1990. link 62 Loy TS, Kyle J, Bickel JT. 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