Pseudomonas aeruginosa Acute Prostatitis and Urosepsis after Sexual Relations in a Hot Tub

Abstract

We report a case of a previously healthy 38-year-old male with acute prostatitis and concurrent Pseudomonas aeruginosa urosepsis. Pulsed-field gel electrophoresis analysis confirmed that the source of the organism was the patient's newly purchased hot tub, which was filled with water from a stream. CASE REPORTA previously healthy 38-year-old white male presented to the emergency room with a 10-hour history of fevers, chills, and significant suprapubic pain. He also complained of dysuria and feelings of incomplete emptying after voiding. He denied any history of sexually transmitted diseases, recent urinary tract infections, or genitourinary trauma. He did mention having sexual relations with his wife three times the previous week in a newly purchased hot tub. His wife was asymptomatic.He received 6 liters of crystalloid fluid for hypotension in the emergency department. A Foley transurethral catheter was placed for urinary output measurement prior to urology consultation. A computed tomography scan of the abdomen and pelvis revealed significant soft tissue stranding surrounding the prostate, seminal vesicles, and posterior aspect of the bladder.

Fatal Pseudomonas aeruginosa pneumonia in a previously healthy woman was most likely associated with a contaminated hot tub

“…The occurrence of P. aeruginosa pneumonia in the community should always prompt proper environmental investigations in order to elucidate possible sources of infection. Using PFGE, a case of P. aeruginosa urosepsis and prostatitis in a previously healthy 38-year-old was recently linked to contaminated water in the patient’s hot tub; this underlines the considerable potential of today’s molecular subtyping methods as a tool to elucidate sources of infection [ 18 ].…”

“…The detection of 37,000 CFU of P. aeruginosa in a hot tub indicates massive biofilm formation in the bath circulation and severe deficiencies in hygienic maintenance. P. aeruginosa is able to multiply in biofilms that form on the surfaces of pipes filled with stagnant water, and it can grow at temperatures up to 42°C [ 1 , 18 ]. There are a number of regulations governing the microbiological quality of water in hot tubs in commercial premises, such as wellness hotels or health spas; however, in Austria this has been regulated by law only since July 2009 [ 19 ].…”

Prevalence and Antimicrobial-Resistance of Pseudomonas aeruginosa in Swimming Pools and Hot Tubs

“…Swimming pools and hot tubs have even more complex piping systems than sinks and showers, thus increasing the difficulty of cleaning. The temperature range in indoor recreational water is ideal for P. aeruginosa proliferation, which routinely grows in water 4–42 °C [ 8 , 12 , 13 ]. Finally, the high temperature and considerable agitation/aeration of hot tub water may cause rapid dissipation of halogen levels, thus rendering chlorine-based disinfectants ineffective [ 14 , 15 ].…”

Pseudomonas folliculitis: a complication of the lockdown hot tub boom? Lessons from a patient

“…An association between the gram-negative bacterium P. aeruginosa infection and exposure to contaminated recreational water in hot tubs, both in commercial and domestic settings, has been well documented since the 1970s, 3 with cases of otitis externa 4 and genitourinary tract infections, 5 as well as respiratory tract infections, including a fatal pneumonia 6 in a previously fit patient, reported to have been caused by P. aeruginosa acquired from hot tubs. The warm, wet environment of hot tubs provide the ideal conditions for P. aeruginosa to proliferate 7 and the complex plumbing systems may facilitate biofilm formation and pose a significant decontamination challenge, as seen in this case.…”