What type of patient is contraindicated for prostate exam by DRE?

• A. Acute bacterial prostatitis
• B. Chronic bacterial prostatitis
• C. Benign prostatic hyperplasia
• D. Prostatitis due to fungus

Answer: (A)

The main idea is that an acute bacterial infection in the prostate makes a digital rectal exam unsafe. In acute bacterial prostatitis the gland is inflamed and tender, and manipulating it with a finger can push bacteria from the prostate into the bloodstream or surrounding tissues, increasing the risk of bacteremia and sepsis. Because the priority is to treat the infection with antibiotics and avoid provoking spread or severe pain, the exam is avoided during the acute phase and performed only after the infection is controlled.

Chronic bacterial prostatitis, benign prostatic hyperplasia, and prostatitis due to fungus are not contraindicated in the same way. DRE can be useful or performed with caution to assess size, tenderness, or other signs of disease, and these conditions do not carry the same immediate risk of disseminating infection as acute bacterial prostatitis.