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Acute uropathogen-related cowperitis with sepsis: case report and literature review
Giuseppe Maiolino1, Andrea Boni1, Michele Del Zingaro1
1Department of Surgical and Biomedical Sciences, Division of Urology Clinic, University of Perugia, Perugia, 06129, Italy.
Abstract:
Acute cowperitis, which was previously known as a common complication of sexually transmitted infections (STIs), is now commonly associated with bacterial urinary tract infections, particularly Escherichia coli. Patients often have a history of STIs, and the symptoms resemble other male accessory gland infections (MAGIs). Recent cases associated with sepsis have been managed with percutaneous drainage and/or surgery. We present a case of acute cowperitis with sepsis and an abscess in the right small gland. The diagnosis was made using transperineal ultrasound, and the patient was successfully treated only with a long-term antibiotic therapy.
Insights
Acute cowperitis, previously linked to STIs, is now often caused by E. coli UTIs. A recent case with sepsis was successfully treated with antibiotics alone, challenging surgical management norms.
Area of Science:
- Urology
- Infectious Diseases
- Medical Imaging
Background:
- Acute cowperitis, historically a sexually transmitted infection (STI) complication, is increasingly linked to bacterial urinary tract infections (UTIs), notably by Escherichia coli.
- Symptoms often overlap with other male accessory gland infections (MAGIs), complicating diagnosis.
- Recent severe cases involving sepsis have necessitated invasive interventions like percutaneous drainage or surgery.
Observation:
- A case of acute cowperitis presenting with sepsis and a right-sided small gland abscess was observed.
- Diagnosis was confirmed using transperineal ultrasound, a non-invasive imaging technique.
- The patient's clinical presentation mimicked other male accessory gland infections.
Findings:
- The study highlights a shift in the etiology of acute cowperitis towards bacterial UTIs.
- Transperineal ultrasound proved effective for diagnosing cowperitis with abscess formation.
- Successful treatment was achieved solely through prolonged antibiotic therapy, avoiding surgical intervention.
Implications:
- This case suggests that conservative antibiotic management may be sufficient for acute cowperitis with sepsis, even with abscess formation.
- It challenges the necessity of surgical or drainage procedures in all severe cowperitis cases.
- Further research into non-invasive diagnostic and therapeutic strategies for cowperitis is warranted.
