Community-Acquired Methicillin-ResistantStaphylococcus aureusProstatic Abscess Presenting as Acute Urinary Retention: A Case Report and Review of the Literature

Ali Naboush,Ali Abou Yassine,Mohamad Yasmin,Neville Mobarakai

doi:10.1155/2013/761793

Ali Naboush, Ali Abou Yassine + Show 2 more

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https://doi.org/10.1155/2013/761793

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Abstract

Background. Community-associated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. Prostatic abscess is an uncommon disease. To date, there are only 6 published reports of a prostatic abscess secondary to CA-MRSA. Case Description. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. Physical examination was remarkable for an enlarged nontender prostate. A urine analysis showed pyuria while urine cultures grew CA-MRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. Our treatment regimen included IV vancomycin followed by oral trimethoprim/sulfamethoxazole and rifampin. Eradication of CA-MRSA was confirmed by follow-up cultures 2 months following discharge. Conclusion. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Early treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity.

Highlights

BackgroundCommunity-associated methicillin-resistant S. aureus (MRSA) (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system
Staphylococcus (S.) aureus-induced infections have rapidly increased during the last decade with methicillin-resistant S. aureus (MRSA) currently accounting for >50% of staphylococcal disease [1]
Formerly considered to be an organism solely limited to healthcare contact, communityassociated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system [2]

Summary

Background

Community-associated MRSA (CA-MRSA) strains have emerged as a substantial cause of infection in individuals without exposure to the healthcare system. There are only 6 published reports of a prostatic abscess secondary to CA-MRSA. A 52-year-old diabetic Caucasian presented to the emergency department with severe lower abdominal pain of few hours duration, urinary frequency, and dribbling over the last 3 weeks. A urine analysis showed pyuria while urine cultures grew CAMRSA. Computed tomography of the abdomen and pelvis showed multiple prostate abscesses and a thickened urinary bladder wall. A TURP was performed by the urology team and pathology showed severe acute and chronic prostatitis with abscess formation and necrotic tissue. This case illustrates the successful identification, diagnosis, and prompt treatment of a prostatic abscess secondary to CA-MRSA in a diabetic patient without recent hospitalization. Treatment with antibiotics and transurethral resection of the prostate abscess led to a shortened hospital stay and decreased morbidity

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