Prostatic Abscess on Xanthogranulomatous Prostatitis: Uncommon Complication of an Uncommon Disease

Jabbour, Youness; Lamchahab, Hamza; Sumba, Harrison; Ouazzani, Hafsa El; Karmouni, Tarik; Khader, Khalid El; Koutani, Abdellatif; Andaloussi, Ahmed Iben Attya

doi:10.1155/2018/5417903

Cited by 5 publications

(6 citation statements)

References 14 publications

(38 reference statements)

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“…Even more uncommon is the concurrent presentation of a prostate abscess in the setting of XGP, with as few as five cases documented in the literature prior to this. 2 Our case highlights the possibility of XGP diagnosed in the setting of prostate cancer and prostate abscess, which further complicates the diagnosis. Therefore, this case stresses the need to pay close attention to the histopathology and any other concurrent disease, such as prostate abscess, in order to ensure accurate diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 89%

“… 1 It has also been associated with prostatic abscess at the time of transurethral resection of the prostate. 2 …”

Section: Introductionmentioning

confidence: 99%

“… 1 , 4 The presenting PSA is variable, ranging from 0.5 to 172 ng/dL. 2 , 3 In those with significant elevations in PSA >150 ng/dL, decline in the PSA levels began 4 months after surgical treatment and decreased to 6 ng/dL 17 months after resection. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

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An improbable trifecta: Occurrence of xanthogranulomatous prostatitis, prostate cancer, and prostatic abscess in a single patient

Demeter

Deshmukh

Salari

et al. 2021

Urology Case Reports

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Xanthogranulomatous prostatitis (XGP) is a rare disease that can mimic the clinical and imaging findings of prostate cancer. Differentiation of these diseases is vital in order to offer the correct treatment. Histological examination of prostate tissue is the definitive manner in which XGP is distinguished from prostate cancer. This case demonstrates the rare possibility of concurrent findings of prostate abscess, prostate cancer, and XGP, further clouding diagnostic assessment. Percutaneous aspiration and antibiotic treatment of the abscess reduced lower urinary tract symptoms and eliminated XGP on subsequent prostate biopsy. Careful work up is necessary to prevent unnecessary interventions or missed diagnoses.

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Section: Discussionmentioning

confidence: 89%

“… 1 It has also been associated with prostatic abscess at the time of transurethral resection of the prostate. 2 …”

Section: Introductionmentioning

confidence: 99%

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An improbable trifecta: Occurrence of xanthogranulomatous prostatitis, prostate cancer, and prostatic abscess in a single patient

Demeter

Deshmukh

Salari

et al. 2021

Urology Case Reports

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“…Sepsis due to a prostate abscess is also a frequent mode of presentation. 7,8,10,19,20 Further, XGP is found to result in the formation of fistulae. Cases of an entero-vesical fistula 5 and a prosto-rectal fistula 18 due to XGP have been reported.…”

Section: Discussionmentioning

confidence: 96%

Different clinical presentations of xanthogranulomatous prostatitis: A case series and review of the literature

Silva

Sooriyaarchchi

et al. 2020

Journal of Clinical Urology

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Objective: Xanthogranulomatous prostatitis (XGP) is a rare entity that has different clinical presentations. This report of three cases illustrates the diversity of clinical features of XGP, together with a comprehensive literature review. Methods: Three elderly male Sri Lankan patients underwent transurethral resection of the prostate for severe lower urinary tract symptoms. Carcinoma of the prostate was suspected in two patients, and one of them had a very high prostate-specific antigen level (324 ng/mL), suggestive of metastatic prostate carcinoma. The third patient had a clinically benign prostate gland. The histology of all three resected prostate chippings revealed XGP. Results: This case series encompasses two cases of XGP that mimicked carcinoma of the prostate clinically and another case that had benign clinical features. Patients with XGP can have clinical, radiological and serological evidence of advanced prostate carcinoma. Other rare modes of presentation of XGP include prostate abscess and haematospermia. Many concerns of XGP such as aetiology, epidemiology, natural history, risk of malignant transformation and possible treatment options remain unclear due to the paucity of the literature. Conclusions: XGP presents with a variety of benign and malignant clinical features. The possibility of encountering XGP in patients with clinically malignant prostates should not be overlooked.

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“…Xanthogranulomatous (XG) prostatitis is a rare form of granulomatous prostatitis characterized by a benign inflammatory process of non-specific etiology that clinically may mimic carcinoma [1]. Few cases have been reported in the English literature, with only four reported cases presenting as prostatic abscesses [[2], [3], [4], [5]]. Infectious etiologies of granulomatous prostatitis include bacteria, fungi, viruses, and parasites [5]].…”

Section: Introductionmentioning

confidence: 99%

Xanthogranulomatous prostatitis presenting as Pseudomonas aeruginosa prostatic abscesses: An uncommon complication after kidney transplantation

Belga

Chen

Low

et al. 2019

IDCases

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Xanthogranulomatous (XG) prostatitis is a rare form of granulomatous prostatitis characterized by a benign inflammatory process of non-specific etiology that clinically may mimic carcinoma. Few cases have been reported in the English language medical literature, with only four reported cases presenting as prostatic abscesses. A 70-year-old male with type 2 diabetes mellitus and two previous kidney transplants presented with septic shock secondary to Pseudomonas aeruginosa bacteremia 4 days after undergoing a cystoscopy. Despite appropriate antimicrobial therapy , P. aeruginosa persisted in the blood for a total of 7 days. There were no indwelling prosthetic devices, no complicated pyelonephritis, and no endovascular sources of infection. Upon repeat clinical assessment, the patient reported pelvic pain. A digital rectal examination revealed prostatic tenderness and an endorectal ultrasound confirmed multiple prostatic abscesses. An ultrasound-guided transrectal needle aspirate drained scant purulent fluid and cultures grew the same phenotypic strain of P. aeruginosa . For definitive source control, the patient underwent transurethral resection of the prostate with unroofing of prostatic abscesses. The pathological findings were diagnostic of XG prostatitis. Given the rather acute presentation of this case, our hypothesis is that the prior urological instrumentation likely facilitated bacterial translocation and created the ideal environment for the development of pseudomonal prostatic abscesses resulting in XG inflammation and necrosis. XG prostatitis is a rare entity of uncertain etiology that can result in prostatic abscesses, and surgery is required for definitive diagnosis and management.

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Prostatic Abscess on Xanthogranulomatous Prostatitis: Uncommon Complication of an Uncommon Disease

Cited by 5 publications

References 14 publications

An improbable trifecta: Occurrence of xanthogranulomatous prostatitis, prostate cancer, and prostatic abscess in a single patient

An improbable trifecta: Occurrence of xanthogranulomatous prostatitis, prostate cancer, and prostatic abscess in a single patient

Different clinical presentations of xanthogranulomatous prostatitis: A case series and review of the literature

Xanthogranulomatous prostatitis presenting as Pseudomonas aeruginosa prostatic abscesses: An uncommon complication after kidney transplantation

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