Roig-Marín N, Roig-Rico P, Bañón-Escandel S, Seguí-Ripoll JM, Calbo-Maiques J, Martín-González C

Language: Spanish
References: 12
Page: 275-279
PDF size: 424.62 Kb.

ABSTRACT

Background: Klebsiella pneumoniae is an agent of prostatitis and prostatic abscess, which in large series only represents 1.1% of cases of prostatitis. This paper reports a case of prostatic abscess with dissemination to liver, lung and testicle, a clinical picture that has not yet been described in the literature.
Clinical case: A 57-year-old male patient, diabetic, smoker with moderate enolic habit, who consulted because of dysuria and polyuria of a week of evolution. Physical examination revealed a 37.8ºC temperature and hepatomegaly. Abdominal ultrasound showed space occupying liver lesions. For a greater appreciation of the lesions, computerized axial tomography (CT) thorax-abdomen-pelvis was requested showing compatible findings with prostatic abscesses with hematogenous spread to lung and liver. Testicular ultrasound was performed, showing orchidoepididymitis and left testicular abscess. multi-sensible Klebsiella pneumoniae was isolated in blood cultures; disappearing all abscesses in 6 weeks with antibiotic treatment.
Conclusions: The unusual location of the dissemination of the infection presented by our patient is remarkable, it has not been described to date. On the other hand, the favorable response to medical treatment is remarkable.

REFERENCES

1. Domínguez-Berrot AM, de San Luis-González LC, Pascual- Palacín R, Álvarez-Ruiz A, et al. Prostatic abscess as a unusual cause of septic shock. Med Intensiva 2004; 28: 222-4. https://doi.org/10.1016/S0210-5691(04)70050-9.

2. Skerk V, Krhen I, Schonwald S, Cajic V, et al. The role of unusual pathogens in prostatitis syndrome. Int J Antimicrob Agents 2004; 24 (Suppl 1): S53. doi. 10.1016/j.ijantimicag. 2004.02.010.

3. Liu KH, Lee HC, Chuang YC, Tu CA, et al. Prostatic abscess in southern Taiwan: another invasive infection caused predominantly by Klebsiella pneumoniae. J Microbiol Immunol Infect 2003; 36:31.

4. Bae GB, Kim SW, Shin BC, Oh JT, et al. Emphysematous prostatic abscess due to Klebsiella pneumoniae: report of a case and review of the literature. J Korean Med Sci 2003; 18 (5): 758-60. doi. 10.3346/jkms.2003.18.5.758.

5. Kuo PH, Huang KH, Lee CW, Lee WJ, et al. Emphysematous prostatitis caused to Klebsiella pneumoniae. J Formos Med Assoc 2007; 106 (1): 74-7. doi. 10.1016/S0929- 6646(09)60219-9.

6. Cheng DL, Liu YC, Yen MY, Liu CY, et al. Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients. Arch Intern Med 1991; 151 (8): 1557-9.

7. Siu LK, Yeh KM, Lin JC, Fung CP, et al. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 2012; 12 (11): 881-7. https://doi.org/10.1016/S1473- 3099(12)70205-0.

8. Chung SD, Keller J, Lin HC. Greatly increased risk for prostatic abscess following pyogenic liver abscess: a nationwide population-based study. J Infect 2012; 64 (4): 445-7. doi. 10.1016/j.jinf.2012.01.003.

9. Chuang LH, Song HS, Lee SC, Lai CC, et al. Endogenous Klebsiella pneumoniae endophthalmitis associated with prostate abscess: case report. Chang Gung Med J 2000; 23 (4): 240-5.

10. Chew LC. Septic monoarthritis and osteomyelitis in an elderly man following Klebsiella pneumoniae genitourinary infection: case report. Ann Acad Med Singapore 2006; 35 (2): 100-3.

11. Liao C, Yang Y, Yeh Y, Ben R, et al. Invasive liver abscess syndrome predisposed by Klebsiella pneumoniae related prostate abscess in a nondiabetic patient: a case report. BMC Research Notes 2016; 9 (1): 395. doi. 10.1186/ s13104-016-2188-y.

12. Liu J, Lin T, Chang Y, Tsai C, et al. Prostatic abscess of Klebsiella pneumonia complicating septic pulmonary emboli and meningitis: A case report and brief review. Asian Pac J Trop Med 2017; 10 (1): 102-105. doi. 10.1016/j. apjtm.2016.11.014.