A Rare Case of Prostatic and Bilateral Renal Abscesses Caused by Community-acquired Methicillin-resistant Staphylococcus aureus Infection.

Vrinda Vyas,Timothy Endy

doi:10.7759/cureus.7046

Abstract

Gram-negative bacilli are usually implicated in the formation of prostatic abscesses (PA) which is a rare complication of prostatitis. However, PA methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a substantial cause of PA in recent years. Predisposing factors for MRSA prostatitis include immunocompromised states such as human immunodeficiency virus (HIV), uncontrolled diabetes, intravenous drug use (IVDU), urethral instrumentation, bladder outlet obstruction, preexisting prostatic disease, recent prostatic procedure, and chronic dialysis among others. MRSA PA should be promptly diagnosed and appropriately treated as delay in diagnosis can be detrimental. We present a case of a patient with a remote history of IVDU who developed simultaneous bilateral renal and PA caused by MRSA in the absence of MRSA bacteremia. Since our patient did not have the traditional risk factors for MRSA infection, we can argue that he was infected by the community-acquired strains of MRSA.

Highlights

A prostatic abscess (PA) is an uncommon consequence of bacterial prostatitis
We report a case of a 53-year-old patient with a history of injection drug use who presented with suprapubic tenderness, and was found to have bilateral renal and PA caused by methicillin-resistant Staphylococcus aureus (MRSA) in the absence of MRSA bacteremia
He underwent drainage of renal abscesses and required a prolonged antibiotic course. We report this case to highlight that MRSA infection is increasingly being identified in unusual sites including the urinary tract and prostate

Summary

Introduction

A prostatic abscess (PA) is an uncommon consequence of bacterial prostatitis. It is commonly a result of infection with Escherichia coli and other gram-negative bacteria of the Enterobacteriaceae family. We report a case of a 53-year-old patient with a history of injection drug use who presented with suprapubic tenderness, and was found to have bilateral renal and PA caused by methicillin-resistant Staphylococcus aureus (MRSA) in the absence of MRSA bacteremia. He underwent drainage of renal abscesses and required a prolonged antibiotic course. We report this case to highlight that MRSA infection is increasingly being identified in unusual sites including the urinary tract and prostate.

Discussion

Conclusions

Disclosures

Findings

Finland M