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社区获得性耐甲氧西林金黄色葡萄球菌感染导致前列腺及双侧肾脓肿1例罕见病例

A Rare Case of Prostatic and Bilateral Renal Abscesses Caused by Community-acquired Methicillin-resistant Staphylococcus aureus Infection.

作者信息

Vyas Vrinda, Endy Timothy

机构信息

Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

出版信息

Cureus. 2020 Feb 19;12(2):e7046. doi: 10.7759/cureus.7046.

Abstract

Gram-negative bacilli are usually implicated in the formation of prostatic abscesses (PA) which is a rare complication of prostatitis. However, PA methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a substantial cause of PA in recent years. Predisposing factors for MRSA prostatitis include immunocompromised states such as human immunodeficiency virus (HIV), uncontrolled diabetes, intravenous drug use (IVDU), urethral instrumentation, bladder outlet obstruction, preexisting prostatic disease, recent prostatic procedure, and chronic dialysis among others. MRSA PA should be promptly diagnosed and appropriately treated as delay in diagnosis can be detrimental. We present a case of a patient with a remote history of IVDU who developed simultaneous bilateral renal and PA caused by MRSA in the absence of MRSA bacteremia. Since our patient did not have the traditional risk factors for MRSA infection, we can argue that he was infected by the community-acquired strains of MRSA.

摘要

革兰氏阴性杆菌通常与前列腺脓肿(PA)的形成有关,前列腺脓肿是前列腺炎的一种罕见并发症。然而,耐甲氧西林金黄色葡萄球菌(MRSA)近年来已成为前列腺脓肿的一个重要病因。MRSA前列腺炎的易感因素包括免疫功能低下状态,如人类免疫缺陷病毒(HIV)感染、未控制的糖尿病、静脉吸毒(IVDU)、尿道器械操作、膀胱出口梗阻、既往前列腺疾病、近期前列腺手术以及慢性透析等。MRSA前列腺脓肿应及时诊断并进行适当治疗,因为诊断延迟可能有害。我们报告一例有静脉吸毒史的患者,该患者在无MRSA菌血症的情况下发生了由MRSA引起的双侧肾脏和前列腺脓肿。由于我们的患者没有MRSA感染的传统危险因素,我们可以认为他是被社区获得性MRSA菌株感染的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/666c/7083255/f2dc3727aadc/cureus-0012-00000007046-i01.jpg

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