Emphysematous Prostatic Abscess Due toKlebsiella pneumoniae: Report of a Case And Review of the Literature

Abstract

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.

Transurethral Drainage of Prostatic Abscess: Points of Technique

“…Computed tomography (CT) scans confirmed the abscess in 7 patients (Figure 2). CT scans of our series detected 2 cases with an extraprostatic extension to ischiorectal fossa and in 1 case, detected emphysematous prostatitis, a rare condition (8). …”

Emphysematous prostatic abscess: A case report and review of literature

“…Surgical drainage can be done with transrectal, transperineal or transurethral approach. 5 Transrectal aspiration of prostatic abscess is performed under TRUS guidance and local anesthesia. Perineal incision and transperineal prostatic puncture aspiration are also reported.…”

Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

“…The majority of patients present in their fifth or sixth decade of life and they have other predisposing factors including diabetes mellitus, liver cirrhosis, intravesical obstruction and prior genitourinary tract instrumentation and bladder catheterization [1][2][3][4][5]. This disease can be diagnosed at an early stage with advanced diagnostic modalities such as ultrasound, CT or MRI [1][2][3][4][5]. Appropriate antibiotics with early incision and drainage may result in favorable outcomes.…”

“…A delayed diagnosis can cause high mortality and morbidity, so a prompt clinical diagnosis of this condition is essential [1][2][3][4][5]. The majority of patients present in their fifth or sixth decade of life and they have other predisposing factors including diabetes mellitus, liver cirrhosis, intravesical obstruction and prior genitourinary tract instrumentation and bladder catheterization [1][2][3][4][5].…”

“…This disease entity requires special attention by physicians due to its nonspecific presentation such as dysuria, DOI: 10.3947/ic.2011.43.1.64 • Infect Chemother 2011;43(1):64-67 65 www.icjournal.org frequency, urgency, fever, acute urinary retention and/or perineal pain [1][2][3][4][5]. Some authors have demonstrated that this condition is an uncommon, but relatively serious disease with high mortality and morbidity [1][2][3][4][5]. We report herein on a case of emphysematous prostatitis combined with liver abscess caused by K. pneumoniae.…”