MANAGEMENT OF HUGE PROSTATE ABSCESS IN A YOUNG PATIENT - A CASE REPORT

Abstract

A prostate abscess is a localized collection of purulent fluid within the prostate, which is often seen as a complication of acute bacterial prostatitis. A 20-year-old patient presented with a 14-day history of increased urinary frequency, dysuria, fever, left gluteal pain and obstipation. The patient claimed that he was not sexually active and did not have any chronic diseases or history of surgical procedures. The digital rectal examination was painful and a firm tumefaction with smooth wall was found. Complete blood count with differential was made and it showed elevated inflammatory markers (WBC- 28 x10^9/L, CRP-220 mg/L). An abdominal ultrasound and pelvic MRI scan revealed a cystic lesion 49x67x94 mm found in the prostate. A needle was inserted inside the lesion via transrectal ultrasound (TRUS), and 95 ml of purulent drainage was aspirated. The patient was treated with broad-spectrum intravenous antibiotics – ceftriaxone and ciprofloxacin. The symptoms disappeared immediately after the procedure. Microbiological culture from the purulent specimen was made and it was positive on Peptococcus, sensitive on both antibiotics. The patient was discharged 4 days following the intervention.