Prostate-specific antigen levels in acute and chronic bacterial prostatitis.

Prostate-specific antigen (PSA) is now widely accepted as a useful tumor marker for the diagnosis and follow-up of prostatic cancer. An elevated level of PSA has been asserted to be highly specific for prostate cancer, although patients with large benign prostate glands and those with bacterial prostatitis may also have slightly elevated levels. We measured the serum PSA level in the patients with acute and chronic bacterial prostatitis and consecutively monitored the PSA level in 6 patients who had acute prostatitis and an elevated PSA level. The PSA level was found to be elevated during the acute phase of prostatic inflammation, and the elevated, PSA level in the patients with acute prostatitis returned to the normal level within 14 days after initiation of antimicrobial therapy in all 6 patients. In one patient with chronic prostatitis the elevated PSA level persisted after antibiotic treatment. He was found to have adenocarcinoma by transrectal ultrasonography and biopsy. A markedly elevated serum PSA level in bacterial prostatitis can cause confusion in the diagnosis of prostatic carcinoma. Therefore, PSA determination should be obtained after complete clinical resolution of inflammation to exclude prostatic malignant involvement.