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Sinusitis, chronic, prostatitis, inflammation, gout, hypertension. Treatment ?

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ENT Specialist
Practicing since : 1991
Answered : 2546 Questions
I'm a 40 year old male, 6ft 4in male, weight is in proportion to height. No significant past history except I take Lisinopril for hypertension (well controlled) and have had one a episode of Gout in the past (5 years ago). The episode of Gout in my foot lasted for a few days and has never been repeated.

I was completely healthy until 18 months ago when I developed Sinusitis that has become chronic. Have tried anti-biotics and nasal steroid drops but nothing has worked. Then 4 months ago I developed Prostatitis. My Urologist has prescribed Alpha-blockers, anti-inflammatories and 2 different Anti-biotics but again no relief.

I see two different specialists (ENT and Urologist) about the two different conditions but I wondered is there any 'whole-body' condition that could account for both Sinus and Prostate inflammation. It seems strange that I've gone from being healthy to having 2 different imflammatory conditions in 18 months.
Posted Thu, 3 May 2012 in General Health
Answered by Dr. Sumit Bhatti 4 hours later

Thank you for your query.

1. The only diseases in which both the sinuses and the prostate may be involved are Wegener's Granulomatosis (vasculitis) or cancer metastasis. These are rare conditions. Otherwise there is no direct relation between these two conditions.

2. Both sinusitis and prostatitis may be chronic and are so common that they may appear together often.

3. Since you have received antibiotics without relief, one possibility is that the antibiotics were inappropriate for the type of infection or were not easily secreted in sinus secretions and prostatic fluid.

4. Another possibility is that there is a common fungal infection. Fungi are ubiquitous. You may discuss this with your physicians.

5. I would like to introduce you to the concept of Biofilm formation in your sinuses and prostate. The simplest example of Biofilm is the sludge or slime seen in drainage pipes or the moss seen along water channels. The Biofilm represents colonies of different types of bacteria, fungi living together like a 'city' with different micro organisms taking up different tasks or "profession's" like we do in our communities. Some of them secrete a matrix that protects them all. Due to close proximity, these organisms share genetic material and may be genetically distinct from those that are grown in lab cultures. Hence they do not respond to the same antifungals and antibiotics that they show sensitivity to in lab studies.

6. You should review your antibiotics and take a trial of broad spectrum anti-fungal treatment. Before this you may get a CT PNS (Para Nasal Sinuses) and an MRI of the sinuses. Get a sample of prostatic fluid examined and cultured for fungal infection.

Hope I have answered your questions. If you have any follow up queries I will be available to answer them.

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