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Prostatic abscess due to carbapenem-resistant K. pneumonia: A case report
Wen-Qiang Zhou1,2, Zhi Chen2, Xue-Ju Cai3
1Medical Department of Graduate School Nanchang University, Nanchang, Jiangxi Province, China.
Rationale:
Due to the widespread use of broad-spectrum antibiotics, the morbidity of prostate abscesses (PA) has declined dramatically. However, under special circumstances, such as invasive procedures and immunosuppressive conditions, some patients are more likely to develop this disease. Here, we present the case of a 21-year-old man, diagnosed with PA, with a history of chronic steroid use and a long-term indwelling urinary catheter. The pathogen was confirmed as carbapenem-resistant Klebsiella pneumoniae, a rare bacterium. This case indicates that immunodeficiency and invasive catheter use may be risk factors for PA and opportunistic bacterial infections.
Patient Concerns:
A 21-year-old young man presented with sudden onset of high fever (39.7°C). The patient had a history of long-term use of steroids and long-term indwelling urinary catheter. Digital rectal examination revealed obvious swelling and tenderness of the prostate. Subsequent pelvic magnetic resonance imaging showed a high signal lesion measuring 2.1 × 2.9 × 2.8 cm with T1 enhancement and T2 enhancement.
Diagnoses:
On the 8th day of hospitalization, the patient underwent a PA drainage procedure and a pus culture was conducted. Subsequent pus and urine cultures showed the presence of Klebsiella pneumoniae, which exhibited resistance to all injectable carbapenems, cephalosporins, aminoglycosides, piperacillin-tazobactam, and quinolone drugs.
Interventions:
On the 8th day of hospitalization, the patient underwent PA drainage surgery under general anesthesia to drain the abscess and relieve obstruction. After the surgery, the patient received a 2-week treatment of doxycycline.
Outcomes:
Finally, the patient was discharged after recovery and did not experience recurrence during the 6-month follow-up period.
Lessons:
PA is not commonly found, but some patients are more susceptible to this disease under certain host conditions. Immunodeficiency and invasive catheter use may be risk factors for PA and opportunistic bacterial infections. The use of omadacycline for the treatment of carbapenem-resistant Klebsiella pneumoniae infections appears to be effective.
Insights
Prostate abscesses (PA) are rare but can occur in immunocompromised patients with catheters. This case highlights carbapenem-resistant Klebsiella pneumoniae as a cause, emphasizing risk factors and potential treatments.
Area of Science:
- Urology
- Infectious Diseases
- Microbiology
Background:
- Prostate abscesses (PA) have decreased due to antibiotics but remain a risk in specific patient groups.
- Immunosuppression and invasive procedures like urinary catheterization are potential risk factors for PA.
- This case involves a rare instance of PA in a young adult with chronic steroid use and a urinary catheter.
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