細菌產氣性攝護腺膿瘍—病例報告
盧致誠 范文宙
奇美醫療財團法人柳營奇美醫院 外科部 泌尿外科
Bacterial emphysematous prostatic abscess – A Case Report
Chih-Cheng Lu, Wen-Chou Fan
Division of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan
Purpose:
We present a case of emphysematous prostatic infection complicated with multiple organs abscess by Klebsiella pneumoniae.
Materials and Methods:
A 47 year-old male patient suffered from uncontrolled diabetes. Four days before admission, he had fever and general weakness. He visited our emergent department after empirical treatment at local clinic. After admission, intensive care was given due to diabetic ketoacidosis and septic shock. Although multiple drains for liver and lung, spiking fever persisted. Sequential CT showed air and abscess in the prostate region. Urgent transurethral prostate incision was done to drain the abscess. Afterwards, the general condition became stable. He was discharged with oral antibiotics and antidiabetic drugs. After one year follow-up, the patient kept uneventful condition with tight diabetic control.
Conclusion:
Emphysematous prostatic abscess is an unusual acute disease with high morbidity and mortality. The predisposing factors include diabetes mellitus, hepatic cirrhosis, and intravesical obstruction. CT provides a good tool for immediate diagnosis. Treatment of prostatic abscess includes parenteral antibiotics and abscess drainage. Transperineal needle aspiration, transrectal needle aspiration, open perineal incision, and transurethral resection or unroofing are available routes for drainage.