shard-3-neuro-sym Phase C wave-8 2026-05-15 — full §5.5 clinical depth authored, but audit-held at SCAFFOLDED until a real prostatitis workup adapter is registered. 7 NIH-category / context phenotypes encoded as severity_triggers: acute_bacterial_prostatitis (NIH I), chronic_bacterial_prostatitis (NIH II), cnpcfs_chronic_nonbacterial (NIH IIIa+IIIb collapsed), asymptomatic_inflammatory (NIH IV), sepsis_prostatic_abscess, prostatic_calcification, TRUS-bx-induced_acute_prostatitis. Pivot from sibling rows because per-phenotype dossiers do not exist (same engine, different management branch). 5 setting playbooks span the full journey: home (chronic CP/CPPS self-management + sepsis recognition) → outpatient (acute mild ceftriaxone IM + FQ PO × 4–6 wk; chronic FQ × 4–6 wk per culture; CP/CPPS UPOINT-directed multimodal) → ed (acute moderate-severe + abscess concern; IV ceftriaxone + FQ; TRUS / CT) → inpatient (IV abx × 24–72 h afebrile then PO step-down; TRUS for non-responder; total 4–6 wk) → icu (urosepsis with prostatic abscess + shock; SCC 2026 bundle + STAT drainage). NIH I (acute bacterial) regimen — STAT ceftriaxone 1–2 g IV q24h + FQ (cipro 500 BID PO / levo 750 daily PO) then PO step-down per culture × 4–6 wk total to prevent chronic evolution. NIH II (chronic bacterial) regimen — culture-directed FQ × 4–6 wk (cipro 500 BID or levo 750 daily); TMP-SMX DS BID × 6 wk alternative; biofilm penetration matters. NIH IIIa + IIIb (CP/CPPS) regimen — UPOINT framework: U (α-blocker + 5-ARI) + P (CBT, SSRI / SNRI) + O (5-ARI, quercetin / pollen extract) + I (trial FQ × 4–6 wk if supported) + N (tricyclic / gabapentinoid) + T (pelvic floor PT + biofeedback + trigger point release). NIH IV (asymptomatic inflammatory) — NO treatment unless fertility workup. Sepsis + prostatic abscess — broad-spectrum (pip-tazo / cefepime / meropenem per risk) + STAT US-guided drainage (transrectal or transperineal); SCC 2026 bundle. TRUS-bx-induced acute prostatitis — empiric ertapenem 1 g IV q24h OR pip-tazo 4.5 g IV q6h pending culture; FQ-resistant E. coli is common driver; augmented prophylaxis (FQ + amikacin or rectal-swab-directed) per Liss AUA 2014 prevents 40–60% of post-biopsy episodes. AVOID-vigorous-prostatic-massage-in-acute doctrine — bacteremia risk; gentle DRE for diagnosis only in acute (EAU 2013). AVOID-nitrofurantoin-in-prostatitis doctrine — does NOT penetrate prostate; mirrors AVOID-nitrofurantoin-in-pyelo doctrine. PSA AVOID-during-acute doctrine — transiently elevated; defer 6–8 wk post-acute for return-to-baseline (EAU 2013). Schema-blocked downstream: calc.nih_cpsi (NIH-CPSI), protocol.meares_stamey_4_glass, protocol.upoint_phenotyping, panel.eps_ejaculate_culture, uro.cpps.v1, uro.epididymitis.v1, protocol.trus_bx_prophylaxis_augmented — none yet in clinical-tools-registry.ts. Tickets surfaced in depth brief §10. Promoted SCAFFOLDED→INTEGRATED 2026-05-22 (shard-5 build campaign): added 3 registry-resolving workups; replaced all 6 mis-attributed placeholder PMIDs with live-verified prostatitis sources (Krieger NIH classification, Schaeffer NEJM 2006, Shoskes UPOINT 2009, Schaeffer CPPS 2008, Shoskes microbiome 2016, Rees consensus 2015); corrected 5 wrong/invalid RxCUIs (tamsulosin 74169→77492, pip-tazo 68111→74169, TMP-SMX 10180→10831, ertapenem 38122→325642, finasteride 4368→25025) — all RxNav reverse-verified. Sibling pivots: uro.uti.complicated.v1 (chronic bacterial prostatitis IS phenotype of complicated UTI in men), uro.bph.v1 (CP/CPPS UPOINT U domain overlap with BPH α-blocker therapy — this commit ships uro.bph.v1), id.sepsis.core.v1 (urosepsis with prostatic abscess pathway overlap) — all resolve to real engines in ALL_DOSSIERS. Dossier NOT registered in _registry.ts per shard scope (DO NOT TOUCH _registry.ts). Registration deferred to subsequent commit by shard-0 / cross-shard registry maintainer.