Rare Dysuria: Prostatic Abscess due to Disseminated Coccidioidomycosis

Abstract

We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis. Treatment modalities for this challenging fungal disease are also discussed.

Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era

“…38 Other reported bacterial pathogens include Klebsiella pneumoniae, [39][40][41] Enterococcus species, 34,42,43 Streptococcus species, 44 Pseudomonas aeruginosa, 45 Bukholderia pseudomallei [46][47][48] and Brucella melitensis. 49 Atypical organisms are seen more frequently in the severely immunocompromised, such as post-transplant and AIDS patients, 18 and include pathogens seen at a higher incidence in those populations, such as mycobacteria (Mycobacterium avium intracellulare, mTB 50,51 ), as well as pathogenic fungi, such as Coccidioides immitis, 52 Candida species, [53][54][55] Cryptococcus neoformans, 20,56 Blastomyces dermatitidis, 57 Histoplasma capsulatum 58,59 and Cladophialophora carrionii. 60 Although rare overall, there have been numerous reports of PA formation as a result of disseminated mTB amongst HIV/immunocompromised patients, patients with previous BCG therapy and, infrequently, immunocompetent patients.…”

Prostatic abscess: a rare complication of staghorn calculi

“…Like all abscesses, prostatic abscess is often associated with patients with diabetes and are immunocompromised, which was not a feature seen in our case. More interestingly, prostatic abscesses have been reported in patients who had melioidosis infection,12 coccidioidomycosis infection,13 postsalvage cryotherapy for prostate cancer14 and even in a child 15. A secondary cause to a staghorn calculus has not been reported before in the literature.…”