Presentation
However, melioidosis presenting primarily as prostatic abscesses is very rare. [ncbi.nlm.nih.gov]
Entire Body System
- Chills
We report the case of a 49-year-old Japanese man who developed fever and shaking chills during hospitalization for STEMI. We initially diagnosed catheter-associated urinary tract infection. [ncbi.nlm.nih.gov]
He denied any fever, chills or dysuria. [pubs.sciepub.com]
The patients presented with clinical symptoms of dysuria, high fever with chills and rigors, perineal pain, urethral discharge and severe tenderness with or without fluctuation on digital rectal examination. [sjkdt.org]
Pathology of Acute Prostatitis Macroscopic Pathology Enlarged prostate Hyperemia and edema Abscess formation Microscopic Pathology Infiltration by neutrophils in acinar and stromal tissue Microabscesses Signs and Symptoms General complaints: Fever, chills [urology-textbook.com]
- Perineal Pain
Diagnosis Prostate ultrasonography and possibly cystoscopy Abscess is suspected in patients with persistent perineal pain and continued or recurrent UTIs despite antimicrobial therapy. [merckmanuals.com]
Symptoms of Prostate Abscess Common symptoms include Urinary frequency Dysuria Urinary retention Perineal pain, evidence of acute epididymitis, hematuria, and a purulent urethral discharge are less common. Fever is sometimes present. [msdmanuals.com]
After treatment, the perineal pain and fever subsided in all the cases. [sjkdt.org]
Worsening suprapubic and perineal pain Straddle injury to urethra, urethroplasty, hepatitis C No Cope loop catheter placement Vancomycin Resolution [ 33 ] 43 MRSA Dysuria, hesitancy, slow stream, night sweats, flushing, and perineal pain Intravenous drug [bmcinfectdis.biomedcentral.com]
- Malaise
Case Report A 50-years-old construction worker with a history of poorly controlled diabetes presented with cough, fever, weight loss, malaise, and diffuse abdominal pain of two weeks duration. [ijcasereportsandimages.com]
Sepsis from prostatitis is very rare, but may occur in immunocompromised patients; high fever and malaise generally prompt blood cultures, which are often positive in sepsis. [en.wikipedia.org]
TURP Oxacillin, tobramycin Resolution [ 39 ] 53 MRSA Urinary urgency, fatigue, chills, rigors, and fever Diabetes mellitus, Obesity Yes No drainage Vancomycin, TMP-SMX, rifampin Resolution [ 40 ] 50 MRSA + PVL Abdominal pain, cough, fever, weight loss, malaise [bmcinfectdis.biomedcentral.com]
[…] dribbling _ _ + +/- Difficulty stopping urine stream _ _ + +/- Hematuria _ _ _ + Chronic pelvic pain (prostodynia) _ + _ +/- Enlarged, smooth prostate + +/- + _ Enlarged, firm, irregular prostate +/- _ _ + Prostate tenderness +/- +/- _ _ PMNs in EPS + + _ _ Malaise [antimicrobe.org]
- Recurrent Urinary Tract Infection
Continued or recurrent urinary tract infections (UTIs) despite treatment are also cause for suspicion. Men with these symptoms should undergo prostate ultrasonography and possibly cystoscopy. [merckmanuals.com]
The authors report a case of a 51-year-old man with insulin-dependent diabetes mellitus and recurrent urinary tract infections who was diagnosed with prostatic abscess. [urotoday.com]
For about three months prior to his admission he had been taking antibiotics prescribed by his general practitioner for a presumed diagnosis of recurrent urinary tract infection. [webmedcentral.com]
Gastrointestinal
- Suprapubic Pain
Commonly patients complain of dysuria, fever, suprapubic pain, and possibly urinary retention. Urinalysis reveals leukocytes. Clinically the condition can be similar to acute bacterial prostatitis without abscess formation 8. [radiopaedia.org]
Definition of Acute Prostatitis Acute bacterial prostatitis is characterized by sudden fever, perineal and suprapubic pain and voiding symptoms. The urine analysis reveals a urinary tract infection. [urology-textbook.com]
His urinary symptoms and associated suprapubic pain persisted. He had difficulty ambulating due to pain in his left thigh. [bmcinfectdis.biomedcentral.com]
[…] diabetic patient who presented with dysuria, fatigue, weight loss, and a tender prostate. [6] The third reported case was a patient with human immunodeficiency virus (HIV) and AIDS who presented with fever, dysuria, and suprapubic pain. [7] The fourth [ijcasereportsandimages.com]
However, unlike urinary tract infection alone, men with prostatitis typically have suprapubic, rectal, testicular, scrotal and penile pain, and sexual dysfunction or discomfort, including erectile dysfunction, painful ejaculation and postcoital pelvic [antimicrobe.org]
- Abdominal Pain
Case Report A 50-years-old construction worker with a history of poorly controlled diabetes presented with cough, fever, weight loss, malaise, and diffuse abdominal pain of two weeks duration. [ijcasereportsandimages.com]
Table 1 Summary of the current literature on S. aureus prostatic abscess [ 8 ] 42 MRSA Dysuria, urinary retention, abdominal pain Urinary retention No Transrectal Levofloxacin, metronidazole, fluconazole Resolution [ 14 ] 31 MRSA Dysuria, abdominal pain [bmcinfectdis.biomedcentral.com]
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself [nejm.org]
- Rectal Pain
He had trans-rectal ultrasound scan of prostate which confirmed prostatic abscess and 10 mls of pus aspirated through the guidance of trans-rectal ultrasound scan and entonox to control pain. [webmedcentral.com]
[ 19 ] 47 MRSA Dysuria, pyrexia, urinary frequency, rectal tenesmus, right flank pain None No TURP Vancomycin, piperacillin-tazobactam, linezolid. [bmcinfectdis.biomedcentral.com]
[…] pubic bone Rectal pain Perineal pressure and pain in the scrotum and testes Leukospermia Sexual dysfunction Decreased libido Erectile dysfunction Ejaculatory dysfunction Pain during or after ejaculation General symptoms Fatigue Headache Myalgia Lethargy [antimicrobe.org]
Neurologic
- Confusion
Abstract In the antibiotic era prostatic abscesses are rare and the clinical picture often can be confusing. [ncbi.nlm.nih.gov]
Case presentation: A 72-year-old developed confusion and hypotension during his hospital stay 2 weeks after an orthotropic heart transplant. P. aeruginosa was identified in his blood and urine. [jmmcr.microbiologyresearch.org]
[…] antibiotics. [1], [2], [3] Clinically, the patients present with non-specific symptoms, and the diagnosis is based on digital rectal examination. [4], [5] Although fluctuation is an important diagnostic sign, it may not always be present, [6] creating confusion [sjkdt.org]
Older men with CP/CPPS are more likely to be confused with having benign prostatic hypertrophy or prostate cancer since many of the symptoms and clinical signs of the former condition mimic these diseases.Table 5 outlined the most common clinical manifestations [antimicrobe.org]
- Meningism
Further investigations confirmed cryptococcal meningitis and imaging studies showed a hypodense lesion in the prostate. This proved to be an abscess and it was deroofed transurethrally. [ncbi.nlm.nih.gov]
Urogenital
- Dysuria
Vancomycin, ceftriaxone, daptomycin Resolution [ 15 ] 20 MSSA + PVL Dysuria None Yes Transrectal Ceftriaxone, amikacin, ciprofloxacin, rifampicin, ofloxacin, fosfomycin Resolution [ 16 ] 56 MRSA Dysuria, polyuria, difficulty urinating Diabetes mellitus [bmcinfectdis.biomedcentral.com]
A previously healthy diabetic man presented with dysuria, fatigue, weight loss, a tender prostate, and leukocytosis. Computerized tomography of the abdomen and pelvis demonstrated a large prostatic abscess at the base of the bladder. [ncbi.nlm.nih.gov]
[…] diabetic patient who presented with dysuria, fatigue, weight loss, and a tender prostate. [6] The third reported case was a patient with human immunodeficiency virus (HIV) and AIDS who presented with fever, dysuria, and suprapubic pain. [7] The fourth [ijcasereportsandimages.com]
- Hematuria
Symptoms of Prostate Abscess Common symptoms include Urinary frequency Dysuria Urinary retention Perineal pain, evidence of acute epididymitis, hematuria, and a purulent urethral discharge are less common. Fever is sometimes present. [msdmanuals.com]
Urinalysis showed pyuria as 11-20 WBC/HPF (Normal: 0-5), bacteria 4+ and microscopic hematuria. [pubs.sciepub.com]
Five patients (1.2%) had terminal hematuria in addition. Nine of the 24 patients (37.5%) were diabetic, of whom seven were insulin dependent. [sjkdt.org]
- Prostatic Disease
Since prostatic abscess may not be differentiated from other prostatic disease on the basis of history and physical examination alone, CT can contribute significantly to establishing this diagnosis. [ncbi.nlm.nih.gov]
著者 平野修平, 石井大輔, 竹中浩二, 大山哲平, 杉田敦, 若田部陽司, 村上泰清, 大草洋, 田畑健一, 岩村正嗣, 吉田一成, 馬場志郎 cw ヒト, ヒト, human(primates), 012150, human, 前立腺疾患, ゼンリツセンシッカン, prostatic disease, 054554, *, 膿瘍, ノウヨウ, abscess, 039844, ドレナージ, ドレナージ, drainage(therapy), 054663, drainage, 男性, ダンセイ [togodb.dbcls.jp]
The case is being reported to enlighten the readers about the following facts: Trans-rectal ultrasound should be a routine in the assessment of prostatic diseases to find the true incidence of prostatic abscesses. [ispub.com]
In those patients with S. aureus bacteraemia (SAB), in addition to prostatic disease, vancomycin was again the most frequently used antibiotic, in keeping with international guidelines [ 10 ]. [bmcinfectdis.biomedcentral.com]
- Prostate Tenderness
Rectal examination may disclose prostate tenderness and fluctuance, but prostate enlargement is often the only abnormality, and sometimes the gland feels normal. [msdmanuals.com]
+ +/- + _ Enlarged, firm, irregular prostate +/- _ _ + Prostate tenderness +/- +/- _ _ PMNs in EPS + + _ _ Malaise, involuntary weight loss _ _ _ + PSA >10 ug/ml _ _ _ + Table 6. [antimicrobe.org]
- Pelvic Pain
The most common form is category III, or Chronic Pelvic Pain Syndrome. [books.google.com]
However, unlike urinary tract infection alone, men with prostatitis typically have suprapubic, rectal, testicular, scrotal and penile pain, and sexual dysfunction or discomfort, including erectile dysfunction, painful ejaculation and postcoital pelvic [antimicrobe.org]
It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS). [en.wikipedia.org]
pain or tender prostate. [ijcasereportsandimages.com]
Workup
Diagnostic workup included analysis of midstream urine and abscess fluid for leukocytes and pathogens. Therapeutic options were conservative treatment and/or draining procedures. RESULTS: Predisposing diseases were found in 13 men. [ncbi.nlm.nih.gov]
The authors discuss the diagnosis, workup, and management. From the *Internal Medicine Department and †Infectious Diseases, Scripps Mercy Hospital; and ‡Naval Medical Center San Diego, San Diego, CA. [journals.lww.com]
The diagnostic workup included analysis of midstream urine and abscess fluid culture for pathogens. Therapeutic options included endoscopic trans-urethral incision or trans-perineal aspiration under ultrasound guidance, or conservative therapy. [sjkdt.org]
Ultrasound
- Prostatic Lesion
Coronal View CT scan of abdomen and pelvis showing multiple ring enhancing lesions with in prostate (red arrows) Panel B. A Cross-sectional view CT scan abdomen and pelvis showing prostate abscess (red arrow) Panel C. [pubs.sciepub.com]
Laboratory
- Leukocytosis
A previously healthy diabetic man presented with dysuria, fatigue, weight loss, a tender prostate, and leukocytosis. Computerized tomography of the abdomen and pelvis demonstrated a large prostatic abscess at the base of the bladder. [ncbi.nlm.nih.gov]
His work up revealed mild leukocytosis of 11.4/mm 3. Urinalysis showed pyuria as 11-20 WBC/HPF (Normal: 0-5), bacteria 4+ and microscopic hematuria. [pubs.sciepub.com]
Conclusion: The proposed algorithm based on our experience suggests that patients with PA larger than 2 cm with severe LUTS and/or leukocytosis benefit from TRUS-guided aspiration. [ijri.org]
Treatment
Abstract The treatment for prostate abscesses includes a combination of antimicrobial therapy and surgical drainage of the abscess cavity. [kuscholarworks.ku.edu]
TRUS guided needle aspiration treatment of PA was successful in five of six patients (83.3%). In one patient treatment failed and the abscess recurred 3 weeks after the procedure. [ncbi.nlm.nih.gov]
Prognosis
The patient was discharged 48 h after the puncture with a good prognosis. [ncbi.nlm.nih.gov]
Prognosis - Prostatic malacoplakia associated with prostatic abscess Not supplied. [checkorphan.org]
DWI limited studies only 2 tends to show restriction of diffusion corresponding to hypoechoic lesions on ultrasound ADC limited studies only 2 mean ADC values within the abscesses have been reported to be very low Treatment and prognosis Percutaneous [radiopaedia.org]
With appropriate treatment, the prognosis of acute prostatitis with and without abscess would not differ.” The investigators noted that prostatic abscesses often are found in patients who do not improve with initial therapy. [renalandurologynews.com]
Etiology
He received an empirical antibiotic and antiviral agent intravenously followed by oral prednisolone until the etiology was identified; however, intraocular inflammation in the left eye continued to worsen, followed by the development of subretinal abscess [ncbi.nlm.nih.gov]
[…] prostatitis and chronic pelvic pain syndrome, evidence behind individual therapies and ancillary topics such as erectile dysfunction, infertility, the link between chronic prostatitis and prostate cancer, male interstitial cystitis and the potential etiologic [books.google.com]
It is uncommon, and rarely diagnosed, and it has suffered a great shift in its mortality rate, and in the types of etiologic agents observed since the discovery and use of penicillin (1). [scielo.br]
Etiology of Acute Prostatitis Acute prostatitis is a bacterial infection of the prostate, caused by ascension of bacteria from the urinary tract, please see section urinary tract infection. [urology-textbook.com]
Epidemiology
The authors highlight the importance of considering epidemiological and clinical aspects in the early diagnosis and treatment. [ncbi.nlm.nih.gov]
"[Epidemiology and treatment of acute prostatitis after prostatic biopsy]". Prog. Urol. (in French). 17 (5): 960–3. doi : 10.1016/S1166-7087(07)92397-0. PMID 17969797. ^ Goldman, Lee (2011). Goldman's Cecil Medicine (24th ed.). [en.wikipedia.org]
Classification, epidemiology and implications of chronic prostatitis in North America, Europe and Asia. Minerva Urol Nefrol 2004,56:99-107. [PubMed] 11. Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE. Epidemiology of prostatitis. [antimicrobe.org]
In the last decade, epidemiologic studies have illustrated that MRSAinduced infections have changed from being primarily acquired in hospitals to also being acquired in the community [ 5 ]. [pubs.sciepub.com]
Prevention
It should be drained transurethrally to prevent relapse. [ncbi.nlm.nih.gov]
Prevention - Prostatic malacoplakia associated with prostatic abscess Not supplied. Diagnosis - Prostatic malacoplakia associated with prostatic abscess Not supplied. Prognosis - Prostatic malacoplakia associated with prostatic abscess Not supplied. [checkorphan.org]
If the initial clinical response to therapy is satisfactory and the pathogen is susceptible to the chosen antibiotic, treatment is continued orally (PO) for 30 days to prevent sequelae such as chronic bacterial prostatitis and prostatic abscess formation [emedicine.medscape.com]
Although there is a theoretical possi bility of hematogenous dissemination of the causative organism during trans-urethral deroofing, the use of pre-operative broad-spectrum antibiotics helps in preventing the occurrence of septicemia. 1. [sjkdt.org]
Accurate diagnosis and proper treatment are required to prevent complications such as sepsis and death. ~ References 1. Olivieira P, Andrade JA, Porto HC, Filha JE, Vinhaus AF. Diagnosis and treatment of prostatic abscess. [ijmm.org]