ABSTRACT
Prostatic abscess is uncommon and difficult to diagnose because the clinical presentation may mimic symptoms of lower urinary tract infection. We report here a case of prostatic abscess in a 50-year-old known diabetic male patient, who presented with urinary retention. Clinical diagnosis was done by clinical presentation and ultrasonography. The causative agents i.e., Staphylococcus aureus was isolated from the aspirate and the patient responded to intravenous Ciprofloxacin therapy. No other surgical intervention was required to treat the patient.
Subject(s)
Abscess/microbiology , Diabetes Complications , Humans , Male , Middle Aged , Prostatic Diseases/microbiology , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purificationABSTRACT
CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.
CONTEXTO: La tuberculosis prostática ha sido principalmente descrita en pacientes inmunodeprimidos. Sin embargo, es excepcional como lesión aislada en pacientes inmunocompetentes. CASO CLINICO: Describimos el caso de un varón sano e inmunocompetente con tuberculosis prostática y hallazgos irrelevantes en la urografía de eliminación realizada. La tomografía computerizada (TC) mostró un absceso en próstata, aislándose en el urocultivo Mycobacterium tuberculosis. El tratamiento con isoniazida, rifampicina y pirazinamida fue exitoso.
Subject(s)
Adult , Humans , Male , Prostatic Diseases/diagnosis , Tuberculosis, Male Genital/diagnosis , Antitubercular Agents/therapeutic use , Immunocompetence , Isoniazid/therapeutic use , Mycobacterium tuberculosis/isolation & purification , Prostatic Diseases/drug therapy , Prostatic Diseases/microbiology , Pyrazinamide/therapeutic use , Rifampin/therapeutic use , Tomography, X-Ray Computed , Tuberculosis, Male Genital/drug therapyABSTRACT
PURPOSE: To compare the clinical presentation of prostatic abscess and treatment outcome in two different time frames with regards to etiologies, co-morbid factors and the impact of multidrug resistant organism. MATERIALS AND METHODS: We retrospectively assessed the charts of 48 patients with the diagnosis of prostatic abscess from 1991 to 2005. The period was divided arbitrarily into two different time frames; phase I (1991-1997) and phase II (1998-2005). Factors analyzed included presenting features, predisposing factors, imaging, bacteriological and antibiotic susceptibility profile, treatment and its outcome. RESULTS: The mean patient age in phase I (n = 18) and phase II (n = 30) were 59.22 ± 11.02 yrs and 49.14 ± 15.67 respectively (p = 0.013). Diabetes mellitus was most common predisposing factor in both phases. Eleven patients in phase II had no co-morbid factor, of which nine were in the younger age group (22 - 44 years). Of these eleven patients, five presented with pyrexia of unknown origin and had no lower urinary tract symptoms LUTS Two patients with HIV had tuberculous prostatic abscess along with cryptococcal abscess in one in phase II. Two patients had melioidotic prostatic abscess in phase II. The organisms cultured were predominantly susceptible to first line antibiotics in phase I whereas second or third line in phase II. CONCLUSION: The incidence of prostatic abscess is increasing in younger patients without co-morbid factors. The bacteriological profile remained generally unchanged, but recently multi drug resistant organisms have emerged. A worrying trend of HIV infection with tuberculous prostatic abscess and other rare organism is also emerging.
Subject(s)
Adult , Humans , Male , Middle Aged , Abscess/microbiology , Anti-Bacterial Agents/adverse effects , Enterobacteriaceae Infections/complications , Prostatic Diseases/microbiology , Abscess/pathology , Anti-Bacterial Agents/therapeutic use , Brazil , Diagnosis, Differential , Diabetes Complications/drug therapy , Drug Resistance, Multiple, Bacterial/physiology , Enterobacteriaceae Infections/drug therapy , Fever/microbiology , Prostatic Diseases/pathology , Retrospective Studies , Time Factors , Treatment OutcomeABSTRACT
El absceso prostático es un cuadro poco frecuente en estos días, sin embargo, es una patología de gravedad si no se trata oportunamente con un diagnóstico rápido y un tratamiento activo. Se reporta el caso de un hombre joven, con un absceso prostático que requirió de drenaje quirúrgico (RTU), evolucionando de forma favorable. Se realiza una revisión de la literatura con respecto a la etiología, factores predisponentes, presentaciones clínicas, diagnóstico y tratamiento de esta patología.
The prostatic abscess is an uncommon disease, however it is a serious illness, if it is not treated timely with a rapid diagnosis and active treatment. We report the case of a young man with a prostatic abscess that required surgical drainage (RTU), evolving in a favorable manner. A review of the literature regarding the etiology, predisposing factors, clinical presentations, diagnosis and treatment of this pathology.