Community acquired methicillin resistant staphylococcus aureus (CA-MRSA) prostatic abscess in a diabetic patient

Javeed, Iqra; Kaushik, Parul; Chowdhury, Mashiul; Palermo, Brandon; Emery, Christopher L.

doi:10.5348/ijcri-2012-91-cr-5

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…Common risk factors included associated skin and soft tissue infections, a history of genitourinary disease or instrumentation, diabetes mellitus, IDU, hepatitis C infection, and the presence of immunodeficiency state. This is similar to current published literature [2, 9–12]. One patient had no identifiable risk factors but had MRSA bacteremia, and it is likely that the PA developed from the hematogenous seeding of the prostate after diagnostic delay and inadequate initial antibiotic therapy [13].…”

Section: Discussionsupporting

confidence: 85%

Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Walker

Heidel

Shorman

2019

Open Forum Infectious Diseases

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Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

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Section: Discussionsupporting

confidence: 85%

Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Walker

Heidel

Shorman

2019

Open Forum Infectious Diseases

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“…Worsening suprapubic and perineal painStraddle injury to urethra, urethroplasty, hepatitis CNoCope loop catheter placementVancomycinResolution[33]43MRSADysuria, hesitancy, slow stream, night sweats, flushing, and perineal painIntravenous drug abuse, hepatitis CYesTURPVancomycin, nafcillin, TMP-SMXResolution[34]63MRSAUrinary retention, pyrexiaRecent scrotal drainage, T2DMYesPercutaneous, TURPVancomycinUnknown[35]59SA [unknown susceptibility]Difficulty passing urineRecent salivary gland abscess treated with antibioticsNoTransperineal, TURPCiprofloxacin, erythromycinResolution[36]35SA“clinical acute prostatitis”HIV, bilateral renal abscessesNoNo drainage“IV antibiotics”Resolution[37]42MSSADysuria. urethral discharge, perineal painNoNoTransperinealOxytetracyclineResolution[38]43SA [unknown susceptibility]Dysuria, haematuria, pyrexia, purulent dischargeRecent pelvic infection and pelvic surgeryNoTransurethralGentamicin, carbenicillin.Resolution after relapse[9]54MSSAPerineal painMycosis fungoidesNoTransperineal, TURPOxacillin, tobramycinResolution[39]53MRSAUrinary urgency, fatigue, chills, rigors, and feverDiabetes mellitus, ObesityYesNo drainageVancomycin, TMP-SMX, rifampinResolution[40]50MRSA + PVLAbdominal pain, cough, fever, weight loss, malaiseDiabetes mellitusYesCT guided drainageVancomycin, levofloxacin, daptomycinResolution[41]46MRSAAcute urinary retention, dysuria, constipationInstrumentationYesTransurethralIV Ant...…”

Section: Resultsmentioning

confidence: 99%

Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature

et al. 2017

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BackgroundProstatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature.Case presentationWe present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant.Conclusions S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2605-4) contains supplementary material, which is available to authorized users.

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“…There is an increasing number of reports of MRSA associated with prostatic abscess [1–4]. A number of different theories exists regarding causation which includes the following.

Retrograde flow of contaminated urine during micturation.

Prostatitis, acute or chronic.

Hematogenous spread from distant foci including skin, respiratory, and gastrointestinal sites.

…”

Section: Discussionmentioning

confidence: 99%

Case Report of a Prostatic Abscess with a Review of the Literature

Flannery

Humphrey

2012

Case Reports in Medicine

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A middle age male with type 2 diabetes mellitus presented with urinary symptoms. Blood and urine cultures were consistent with Methicillin Resistant Staphylcoccal Aureus (MRSA). A computed tomography demonstrated mutiple prostatic microabscessess. No other hematogenous source was identified. Transurethral prostatic drainage and intravenous Vancomycin followed by oral doxcycline led to clinical success for this likely Community acquired case of MRSA (CA-MRSA). We discuss our case report and discuss the current literature on the trends, causation, diagnosis and treatment of MRSA induced prostatic abscess.

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Community acquired methicillin resistant staphylococcus aureus (CA-MRSA) prostatic abscess in a diabetic patient

Cited by 9 publications

References 13 publications

Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature

Case Report of a Prostatic Abscess with a Review of the Literature

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