Department of Urology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, P.R. China.
Outpatient Department of Infection, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, P.R. China.
Am J Mens Health. 2022 Jul-Aug;16(4):15579883221108898. doi: 10.1177/15579883221108898.
The prostatic abscess is a rare complication of a bacterial infection of the prostate. Since the early use of potent antibiotics to treat urinary tract infections, the incidence of the prostatic abscess has declined significantly. In keeping with that, prostatic abscess combined with abscesses in the spleen or other distant organs become an extremely rare but fatal clinical condition. Here, we present a case of prostate and spleen abscess due to multi-drug-resistant gram-negative bacilli without obvious risk factors. The patient initially complained of high-grade fever and dysuria. After screening the source of infection by computed tomography (CT) scans, prostate and spleen abscesses were diagnosed. In addition, extended-spectrum beta-lactamase positive was detected both in urine and blood culture. The patient was successfully treated by a transurethral resection of the prostate followed by splenic puncture and drainage, as well as intravenous administration of meropenem. Although the prostate abscess combined with spleen abscess was rare, the possibility of dissemination in remote tissues should be taken into consideration before the surgical treatment of prostatic abscesses. The concurrent drainage of multiple abscesses followed by intensive and sensitive antibiotics was safe and effective for indicated patients.
前列腺脓肿是前列腺细菌感染的罕见并发症。由于早期使用强效抗生素治疗尿路感染，前列腺脓肿的发病率显著下降。相应地，前列腺脓肿合并脾脓肿或其他远处器官脓肿成为一种极其罕见但致命的临床情况。在这里，我们报告一例多药耐药革兰氏阴性杆菌引起的前列腺和脾脓肿，无明显危险因素。患者最初主诉高热和尿痛。通过计算机断层扫描 (CT) 扫描筛查感染源后，诊断为前列腺和脾脓肿。此外，尿液和血液培养均检测到产超广谱β-内酰胺酶阳性。通过经尿道前列腺切除术，随后进行脾穿刺引流和静脉注射美罗培南，成功治疗了该患者。尽管前列腺脓肿合并脾脓肿较为罕见，但在进行前列腺脓肿的手术治疗之前，应考虑到其在远处组织扩散的可能性。对于有指征的患者，同时引流多个脓肿，然后进行强化和敏感的抗生素治疗是安全有效的。
