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Primary melioidotic prostatic abscess: presentation, diagnosis and management
James K Tan1, Sidney K H Yip, Damian J C Png
1Division of Urology, National University Hospital, Singapore.
ANZ Journal of Surgery
|July 18, 2002
Summary
Melioidosis, a severe sepsis cause in endemic areas, rarely presents as a prostatic abscess. Early diagnosis via transrectal ultrasound and prompt treatment are crucial for recovery.
Area of Science:
- Infectious Diseases
- Urology
- Tropical Medicine
Background:
- Melioidosis, caused by Burkholderia pseudomallei, is a significant cause of severe sepsis in Southeast Asia and Northern Australia.
- Prostatic abscesses are an uncommon presentation of melioidosis.
Purpose of the Study:
- To review the clinical features, diagnostic methods, and treatment outcomes of patients with melioidotic prostatic abscesses.
- To highlight the rarity and potential severity of this presentation.
Main Methods:
- Retrospective review of five patients diagnosed with melioidotic prostatic abscesses between 1997 and 2000.
- Analysis of presenting symptoms, diagnostic investigations (including transrectal ultrasound), and management strategies.
Main Results:
- The average patient age was 53 years, with older age and diabetes mellitus identified as predisposing factors.
- All patients presented with fever (≥38.5°C) and obstructive urinary symptoms, including urinary retention.
- Transrectal ultrasound confirmed prostatic abscesses, which were treated with transurethral resection. One patient experienced severe septic shock, but there was no mortality.
Conclusions:
- Elderly diabetic men in endemic regions presenting with fever and urinary obstruction should be evaluated for melioidotic prostatic abscess.
- Transrectal ultrasound and bacteriological confirmation are essential for diagnosis.
- Effective management involves prompt surgical drainage and appropriate antibiotic therapy.