Prostatic abscess in southern Taiwan

Another invasive infection caused predominantly by Klebsiella pneumoniae

Kuan-Hung Liu, Hsin Chun Lee, Yin Ching Chuang, Chang An Tu, Ko Chang, Nan-Yao Lee, Wen-Chien Ko

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Prostatic abscess, though rarely encountered since the introduction of broad-spectrum antibiotics, can cause significant morbidity and mortality. We retrospectively reviewed 17 cases of prostatic abscess treated during an 11-year period at 2 medical centers in southern Taiwan. Most of these patients were elderly (mean age, 59 years) with diabetes mellitus (10 cases, 59%) or hepatic cirrhosis (5 cases, 29%). Fourteen (82%) of the 17 patients were febrile, with chills occurring in about a half of these. Of the symptoms and signs referable to the lower urinary tract, dysuria (71%) was the most common complaint. Pain was usually localized in the suprapubic (35%) or perineal (18%) area. The common findings of digital rectal examination were prostatic enlargement (77%) and fluctuation (23%). Prostatic abscess was impressed from the findings of hypoechoic area with thick walls on transrectal ultrasound or an enlarged gland with fluid-density collections on computed tomography. All causative pathogens were gram-negative bacilli, including Klebsiella pneumoniae (10 cases), Escherichia coli (2), and Pseudomonas aeruginosa (1). Various measures were undertaken to allow drainage, including transurethral incision or resection of the prostate, open perineal incision, laparotomy, and transrectal ultrasound- or computed tomography-guided needle aspiration. In conclusion, K. pneumoniae was the predominant pathogen of prostatic abscess, and was frequently identified as the causative pathogen in patients with diabetes mellitus. Diagnosis of prostatic abscess based merely on symptomatology is implausible, and image studies, such as transrectal ultrasound or computed tomography scan, are warranted. Optimal management includes adequate drainage of abscess and antimicrobial therapy.

Original languageEnglish
Pages (from-to)31-36
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume36
Issue number1
Publication statusPublished - 2003 Mar 1

Fingerprint

Klebsiella pneumoniae
Taiwan
Abscess
Infection
Tomography
Drainage
Diabetes Mellitus
Dysuria
Digital Rectal Examination
Chills
Urinary Tract
Liver Cirrhosis
Laparotomy
Pseudomonas aeruginosa
Bacillus
Signs and Symptoms
Needles
Prostate
Fever
Escherichia coli

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Prostatic abscess in southern Taiwan: Another invasive infection caused predominantly by Klebsiella pneumoniae",
abstract = "Prostatic abscess, though rarely encountered since the introduction of broad-spectrum antibiotics, can cause significant morbidity and mortality. We retrospectively reviewed 17 cases of prostatic abscess treated during an 11-year period at 2 medical centers in southern Taiwan. Most of these patients were elderly (mean age, 59 years) with diabetes mellitus (10 cases, 59{\%}) or hepatic cirrhosis (5 cases, 29{\%}). Fourteen (82{\%}) of the 17 patients were febrile, with chills occurring in about a half of these. Of the symptoms and signs referable to the lower urinary tract, dysuria (71{\%}) was the most common complaint. Pain was usually localized in the suprapubic (35{\%}) or perineal (18{\%}) area. The common findings of digital rectal examination were prostatic enlargement (77{\%}) and fluctuation (23{\%}). Prostatic abscess was impressed from the findings of hypoechoic area with thick walls on transrectal ultrasound or an enlarged gland with fluid-density collections on computed tomography. All causative pathogens were gram-negative bacilli, including Klebsiella pneumoniae (10 cases), Escherichia coli (2), and Pseudomonas aeruginosa (1). Various measures were undertaken to allow drainage, including transurethral incision or resection of the prostate, open perineal incision, laparotomy, and transrectal ultrasound- or computed tomography-guided needle aspiration. In conclusion, K. pneumoniae was the predominant pathogen of prostatic abscess, and was frequently identified as the causative pathogen in patients with diabetes mellitus. Diagnosis of prostatic abscess based merely on symptomatology is implausible, and image studies, such as transrectal ultrasound or computed tomography scan, are warranted. Optimal management includes adequate drainage of abscess and antimicrobial therapy.",
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Prostatic abscess in southern Taiwan : Another invasive infection caused predominantly by Klebsiella pneumoniae. / Liu, Kuan-Hung; Lee, Hsin Chun; Chuang, Yin Ching; Tu, Chang An; Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien.

In: Journal of Microbiology, Immunology and Infection, Vol. 36, No. 1, 01.03.2003, p. 31-36.

Research output: Contribution to journalArticle

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