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Klebsiella pneumonia-induced prostate abscess: How to work it up?
Jae Hoen Kim1, Won Jae Yang1, Tae Hyong Kim2
1Department of Urology, Soonchunhyang University, College of Medicine, Seoul, South Korea;
Introducton:
Klebsiella pneumonia (KP) is related to a metastatic phenomenon from the originally affected primary organ. About 28% of patients with pyogenic liver abscess arising from KP suffer from metastatic complications. This study was done to define the clinical features of KP-induced prostate abscess.
Methods:
A total of 14 patients were diagnosed with prostate abscess based on clinical, laboratory examination and abdominopelvic computed tomography (CT) scan from 2007 to 2013.
Results:
Among these 14 patients, KP was the dominant causative microorganism in 6 patients (42.9%), followed by Esherchia coli in 2, Pseudomonas aeroginosa in 1, methicillin-resistant Staphyolcoccus aureus in 1, and no growth in either the urine or blood culture in 4. Four (66.7%) of the 6 KP induced-prostate abscess had other concurrent abscess sites besides the prostate: liver in 3, kidney in 1, and perianal area with endogenous endophthalmitis that ended in loss of vision in 1 patient.
Conclusions:
We report on the clinical features of KP-induced prostate abscess based on a small number of patients, which is the main limitation of our study. We believe that if the causative organism of a prostate abscess was KP, more workup would be needed to rule out the presence of an abscess in other organs, especially in the liver. Abdominopelvic CT scan would be a proper imaging modality.
Insights
Klebsiella pneumoniae (KP) can cause prostate abscesses and frequently spreads to other organs, particularly the liver. Further investigation is recommended for KP-induced prostate abscesses to identify concurrent metastatic complications.
Area of Science:
- Urology
- Infectious Diseases
- Radiology
Background:
- Klebsiella pneumoniae (KP) is a pathogen known for causing metastatic infections from primary sites.
- Approximately 28% of patients with KP-induced pyogenic liver abscess develop metastatic complications.
- Prostate abscesses are uncommon, and the clinical characteristics of those caused by KP are not well-defined.
Purpose of the Study:
- To define the clinical features of prostate abscesses caused by Klebsiella pneumoniae.
- To investigate the metastatic potential of KP-induced prostate abscesses.
Main Methods:
- Retrospective analysis of 14 patients diagnosed with prostate abscess between 2007 and 2013.
- Diagnosis was based on clinical presentation, laboratory tests, and abdominopelvic computed tomography (CT) scans.
Main Results:
- Klebsiella pneumoniae was identified as the causative agent in 6 out of 14 patients (42.9%).
- Among the 6 patients with KP-induced prostate abscess, 4 (66.7%) had concurrent abscesses in other organs, including the liver (3 patients) and kidney (1 patient).
- One patient with KP-induced prostate abscess also had a perianal abscess and endogenous endophthalmitis, leading to vision loss.
Conclusions:
- Klebsiella pneumoniae is a significant cause of prostate abscesses and is associated with a high rate of metastatic complications.
- Patients diagnosed with KP-induced prostate abscess require thorough workup to exclude abscesses in other organs, especially the liver.
- Abdominopelvic CT scan is a valuable imaging modality for diagnosing prostate abscess and identifying metastatic spread.
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