Ewha Med J.  2016 Jan;39(1):32-35. 10.12771/emj.2016.39.1.32.

Successful Treatment of Prostatic Abscess Accompanied by Methicillin-Resistant Staphylococcus aureus Bacteremia Using a Percutaneous Fine-Needle Aspiration under the Computed Tomography Guidance

• Lee KH
• Kim DI
• Yun HJ
• Yoon SH
• Yun SR
• Hwang WM

• KMID: 2152756
• DOI: http://doi.org/10.12771/emj.2016.39.1.32

Abstract

Prostatic abscess is not a common entity which is characterized by non-specific clinical presentations. This poses a diagnostic challenge for clinicians. Clinicians routinely consider antibiotic treatments concomitantly with drainage for the treatment of prostatic abscess. But there are no established guidelines for its optimal timing, methods and indications. Surgical drainage procedures include transurethral resection of the prostate and perineal incision and drainage. But there is variability in the prognosis of patients between the procedures. We have treated a 48-year-old diabetes patient with prostatic abscess accompanied by MRSA bacteremia using a percutaneous fine-needle aspiration under the computed tomography (CT) guidance. The patient achieved improvement of the symptoms and in follow up CT findings. A percutaneous drainage under the CT guidance is advantageous in that it causes fewer complications. However, Further studies are warranted to establish the optimal timing, methods and indications in patients with prostate abscess.

Keyword

Prostate abscess; Methicillin-Resistant Staphylococcus aureus bacteremia; Computed tomography guided fine needle aspiration

MeSH Terms

Abscess*
Bacteremia*
Biopsy, Fine-Needle*
Drainage
Follow-Up Studies
Humans
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Middle Aged
Prognosis
Prostate

Figure

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  Fig. 1 Abdomen pelvic computed tomography (admission day). It shows increased size of the prostate accompanied by multiple abscesses (black arrow).

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  Fig. 2 Abdomen pelvic computed tomography (hospital day 7). It shows increased size of prostate abscess that invaded into the adjacent bladder and rectum (black arrow).

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  Fig. 3 Computed tomography (CT) guided fine needle aspiration. It shows fine-needle aspiration at perianal space under the CT guidance (black arrow).

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  Fig. 4 Abdomen pelvic computed tomography (hospital day 22). It shows no further findings that are suggestive of the prostate abscess.

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