血糖控制不良，嚴重攝護腺膿瘍併直腸瘻管：病例報告及文獻回顧
賴元唯1、莊光達1,2、黃一勝1,2
新光吳火獅紀念醫院 外科部 泌尿科1
輔仁大學 醫學系2
Case report: Severe prostate abscess with prostate-rectum fistula on a poor blood sugar control patient
Yuan-Wei Lai1, Guang-Dar Juang 1,2, Thomas I.S. Hwang1,2
Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital1
School of Medicine, Fu-Jen Catholic University2
Abstract:
Gas-forming urinary tract infection (UTI) is first described in 1671. It is a rare and high mortality rate (70–90%) disease. The risk factors to gas-forming UTI include an immunosuppressed status, diabetes mellitus (DM), urethral instrumentation, liver cirrhosis, and alcoholism. Recorded pathogens are Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Citrobacter, and yeasts. Emphysematous prostatic abscess (EPA), which is characterized by gas and purulent exudate formation in the prostate gland, is less reported within gas-forming UTI. The incidence EPA has increased based on the improvement of radiology. Here we are going to introduce a 58-year-old male with poor blood sugar control for decades who from urinary frequency for 1 month with chillness some times. He was diagnosed prostate abscess at LMD and he visited our ER for progressing hematuria a few days later. Severe leukocytosis and high CRP level were detected. Besides, his blood sugar was 560 mg/dL while ketone showed 3.5 mmol/L. CT revealed gas forming prostate abscess with regional extension/adhesion, air in urinary bladder, left vas deference, seminal vesicle and penile shaft.