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Usually an enlarged, firm, and tender prostate is enough to make a presumptive diagnosis and start treatment (prostatic massage is not done for acute bacterial prostatitis).
Because there is usually a low level of bacteria in urine, the doctor will perform a urinalysis to quantitate and identify infecting bacteria by urine culture.
If the person has symptoms suggesting the infection has spread outside the prostate (high fever, chills, urine retention), blood cultures and other blood tests are likely to be ordered.
If a spread of the infection is suspected, a doctor will often perform an ultrasound to help confirm the diagnosis and to rule out an abscess. If this ultrasound is not available, the doctor may perform a CT scan or MRI of the pelvis.
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