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Prostatic Abscess

Prostate Abscess


Presentation

  • We reviewed the 12 previous reported cases of prostatic abscess in newborns and present factors that may suggest the diagnosis. The treatment and outcome in each of the cases are also presented.[ncbi.nlm.nih.gov]
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]
  • 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]
  • He denied any fever, chills or dysuria.[pubs.sciepub.com]
  • No Drainage Vancomycin Resolution [ 31 ] 56 MRSA Difficulty urinating, hematuria, fever, chills and low back pain Diabetes mellitus, BPH, history of self-digital rectal examinations Yes.[bmcinfectdis.biomedcentral.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]
  • 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]
  • The first reported case of CA-MRSA was a patient with a history of intravenous drug abuse (IVDA) and hepatitis C who presented with dysuria, tender prostate, perineal pain, slow urinary stream, and urinary hesitancy. [5] The second reported case was a[ijcasereportsandimages.com]
  • pain Lower Urinary Tract Symptoms: Urinary frequency and urgency Dysuria Weak urinary stream and urinary retention Rectal Examination Painful prostate exam: prostate of soft consistency, possibly with fluctuation as a sign of a prostate abscess.[urology-textbook.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]
  • […] consistency _ _ _ _ Urine 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
  • 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]
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]
  • His urinary symptoms and associated suprapubic pain persisted. He had difficulty ambulating due to pain in his left thigh.[bmcinfectdis.biomedcentral.com]
  • pain. [7] The fourth reported case was a patient with HIV who presented with fever, urinary hesitancy, and intermittent abdominal pain that was relieved following urination. [8] Another case of CA-MRSA prostatitis has been reported by Beckman et al.[ijcasereportsandimages.com]
  • 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]
  • pain _ _ /- Perineal pain _ _ _ Flank pain _ _ _ Tender, enlarged prostate /- _ _ Fever _ _ Chills, rigor _ _ Hypotension _ _ PMNs in EPS _ PSA 4 ug/ml _ _ Ta ble 5.[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]
Thrombosis
  • We decided to treat with antimicrobial agents alone because the patient was receiving dual-antiplatelet therapy and discontinuation is very high risk for in-stent thrombosis.[ncbi.nlm.nih.gov]
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]
Dysuria
  • 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]
  • 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]
  • […] 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]
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]
  • But these abscesses are probably underdiagnosed and their true incidence might emerge if trans-rectal ultrasonography is to become routine in the assessment of prostatic disease in males.[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]
Hematuria
  • Symptoms 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.[merckmanuals.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]
  • Urinalysis showed pyuria as 11-20 WBC/HPF (Normal: 0-5), bacteria 4 and microscopic hematuria.[pubs.sciepub.com]
  • The complications observed were fever ( n 6; 12.5%) and hematuria ( n 7; 14.58%). Seven (14.58%) patients required transurethral resection (TURP; deroofing) of the abscess cavity. In all these patients, "deroofing" was not associated with sepsis.[ijri.org]
  • No Drainage Vancomycin Resolution [ 31 ] 56 MRSA Difficulty urinating, hematuria, fever, chills and low back pain Diabetes mellitus, BPH, history of self-digital rectal examinations Yes.[bmcinfectdis.biomedcentral.com]
Pelvic Pain
  • The most common form is category III, or Chronic Pelvic Pain Syndrome.[books.google.com]
  • pain or tender prostate.[ijcasereportsandimages.com]
  • It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS).[en.wikipedia.org]
  • pain syndrome with inflammation (CP/CPPS-1) _ _ _ III (Subgroup II) Chronic prostatitis/chronic pelvic pain syndrome without inflammation (CP/CPPS-2) _ _ _ _ IV Asymptomatic inflammatory prostatitis (AIP) /- /- * Presence of polymorphonuclear cells ([antimicrobe.org]
Urinary Urgency
  • This patient, with a history of diabetes and hypertension, presented with fever, urinary urgency, chills and fatigue.[ijcasereportsandimages.com]
  • With regard to presentation, the disease manifests as dysuria, urinary urgency and frequency in 96% of cases [10], fever in 30% to 72% [2], [3], [10]and urinary retention in a third of patients [2], [3].[webmedcentral.com]
  • Resolution after relapse [ 9 ] 54 MSSA Perineal pain Mycosis fungoides No Transperineal, TURP Oxacillin, tobramycin Resolution [ 39 ] 53 MRSA Urinary urgency, fatigue, chills, rigors, and fever Diabetes mellitus, Obesity Yes No drainage Vancomycin, TMP-SMX[bmcinfectdis.biomedcentral.com]

Workup

  • Diagnostic workup included TRUS, analysis of midstream urine, and analysis and culture of abscess fluid for leukocytes and pathogens.[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]
Prostatic Lesion
  • Our patient developed fever and his antibiotics were changed to IV Vancomycin and a repeat urinary culture and CT scan abdomen/pelvis were obtained, which revealed increase in the size of the prostate lesion and urine culture remained positive for MRSA[pubs.sciepub.com]
ST Elevation
  • In patients with ST-elevation myocardial infarction (STEMI), urinary tract infection is the most common infection-related complication. Prostatic abscess in a patient with STEMI is very rare.[ncbi.nlm.nih.gov]

Treatment

  • 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]
  • 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]
  • Various factors have influenced the shift of the epidemiological profile of prostatic abscess, such as routine and widespread use of broad-spectrum antibiotics to patients with lower urinary tract symptoms, without the investigation required (4); better[scielo.br]
  • Community-Associated Strains of Methicillin-Resistant Staphylococcus aureus and Methicillin-Susceptible S. aureus in Indigenous Northern Australia: Epidemiology and Outcomes. J Infect Dis. 2009;199(10):1461–70.[bmcinfectdis.biomedcentral.com]
Sex distribution
Age distribution

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]
  • 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]
  • 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]
  • Selection of an appropriate antimicrobial agent that has optimal pharmacokinetics for prostatic tissue is important to prevent treatment failure.[antimicrobe.org]

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