Prostatic Abscess – A Rare Causative Organism

Abstract

A 60-year-old male with diabetes presented with fatigue, urinary frequency, and suprapubic pain for 2 weeks. Patient resides in southern California and denied other symptoms. Laboratory workup showed leukocytosis (16.4 bil/L) and hyperglycemia (463 mg/dL) and urine culture grew 50,000 cfu/mL mixed flora with negative blood cultures. After no clinical improvement with piperacillin/tazobactam for presumed UTI, computed tomography demonstrated a multi-loculated prostatic abscess with regional cystitis (Fig. 1). Chest imaging showed cavitary right upper lobe opacities and miliary pulmonary nodules (Fig. 2). Percutaneous drainage of the prostatic abscess and lung tissue biopsies were obtained (Fig. 3). Figure 2Computed tomography of the chest. (A) Cavitary right upper lobe lesion with background of extensive miliary pulmonary nodules. View Large Image Figure Viewer Download Hi-res image Figure 3Pathology results of lung tissue biopsies. (A) Coccidioides spherule (thick-walled spherule with endospores). View Large Image Figure Viewer Download Hi-res image