Carrillo-Córdova LD, Lemus-Mena GR, Rodríguez-Robles J, Vitar-Sandoval J, Hernández-Farías MA, Jaspersen-Álvarez J, Moreno-Cabrera JC, Acevedo-García C, Jaspersen-Gastelum J, Garduño-Arteaga ML

Language: Spanish
References: 13
Page: 51-56
PDF size: 505.64 Kb.

ABSTRACT

Background: Prostatic abscess is an unusual event, with a 0.5% incidence in relation to all prostatic alterations. Thanks to the devel opment of broad-spectrum antibiotics, its incidence and associated complications have decreased.
Clinical case: A 68-year-old man had a past medical history of type 2 diabetes mellitus of 30-year progression. He presented with general malaise, fever, nausea, and vomiting, with stabbing pain in the perineal region, radiating to the scrotum (5/10 intensity). Physical examination with digital rectal examination revealed a warm, rubbery, 4 x 4-cm prostate, with no suspicion of malignancy. Ultrasound imaging identified a 3.13 x 2.83 x 3.77-cm, 17-g, prostate with a hypoechogenic interior of 3 x 2 x 2 cm and a volume of 12 cc, suggestive of intraprostatic abscess. Abdominopelvic unenhanced and contrast-enhanced computed tomography revealed three hypodense images, suggestive of an intraprostatic collection, of approximately 10 cc each. Diagnosis was prostatic abscess. Treatment consisted of transurethral resection of the prostate. Culture of the purulent matter reported carbapenem-sensitive E. coli. Treatment was completed with that antibiotic.
Conclusions: Prostatic abscess is an uncommon pathology that can potentially lead to multiple organ failure and death, thus requiring opportune diagnosis and early intervention.

REFERENCES

1. Granados EA, Riley G, Salvador J, Vicente J. Prostatic abscess: diagnosis and treatment. J Urol. 1992;148:80-82.

2. Oliveira P, Andrade JA, Porto HC, Filho JE, Vinhaes AF. Diagnosis and treatment of prostatic abscess. Int Braz J Urol. 2003;29:30-34.

3. Langer JE, Cornud F. Inflammatory disorders of the prostate and the distal genital tract. Radiol Clin North Am. 2006;44:665-677.

4. Varkarakis J, Sebe P, Pinggera GM, Bartsch G, Strasser H. Three-dimensional ultrasound guidance for percutaneous drainage of prostatic abscess. Urology. 2004;63:1017- 1020.

5. Bayne CE, Davis WA, Rothstein CP, Engel JD. Seminal vesicle abscess following prostate biopsy requiring transgluteal percutaneous drainage. Can J Urol. 2013;20:6811- 6814.

6. Dell´Atti L. A new ultrasound and clinical classification for management of prostatic abscess. Arch Ital Urol Androl 2017;87(3):246-249.

7. Arrabal-Polo MA, Jimenez A, Arrabal-Martin M. Percutaneous drainage of prostatic abscess: case report and literature review. Urol Int 2012;88:118-120.

8. Collado A, Palou J, Garcia-Penit J, et al. Ultrasoundguided needle aspiration in prostatic abscess. Urology 1999;53(3):548-552.

9. Trauzzi SJ, Kay CJ, Kaufman DG, Lowe FC. Management of prostatic abscess in patients with human immunodeficiency syndrome. Urology 1994;43:629-33.

10. Wen SC, Juan YS, Wang CY, et al. Emphysematous prostatic abscess: case series study and review. Int J Infect Dis 2012;16(5):e344-e349.

11. Puri R, Choudhary NS, Kotecha H, et al. Endoscopic ultrasound-guided pelvic and prostatic abscess drainage: experience in 30 patients. Indian J Gastroenterol 2014;33(5):410-413.

12. Tai HC. Emphysematous prostatic abscess: a case report and review of literature. J Infect 2007;54(1):e51-e54.

13. Sargent JC, Irwin R. Prostatic abscess: a clinical study of 42 cases. Am J Surg. 1931;11:334-7.