Klebsiella pneumoniae in der Prostata

Klebsiella & Healthcare Environments

Vorzeitige Räumung der Prostata

Klebsiella pneumonia KP is related to a metastatic phenomenon from the originally affected primary organ. This study was done to define the clinical features of KP-induced prostate abscess. A total of 14 patients were diagnosed with prostate abscess based on clinical, laboratory examination and abdominopelvic computed tomography CT Klebsiella pneumoniae in der Prostata from to Among these Klebsiella pneumoniae in der Prostata patients, KP was the dominant causative microorganism in 6 patients Four We report on the clinical features of KP-induced prostate abscess based on a small number of patients, which is the main limitation of our study.

We believe that if the causative organism of a prostate abscess was KP, more workup would be needed to rule out the presence of an abscess in other organs, especially in the liver.

Abdominopelvic CT scan would be a proper imaging Klebsiella pneumoniae in der Prostata. Prostate abscess is rare mainly due to the development of broad-spectrum antibiotics which have dramatically reduced its incidence. It is also present in immunosuppressed patients, patients with internal prostheses such as heart valves, joints, or penile implantpatients with acute and chronic bacterial prostatitis, and patients with a recent prostate biopsy.

KP belongs to the family Enterobacteriaceae, which are rod-shaped, gram-negative bacteria with a prominent polysaccharide capsule. This capsule encases the entire cell surface, accounts for the large appearance of the organism on Gram stain, and provides resistance against many host defense mechanisms.

After obtaining institutional review board approval, we examined all cases of prostate abscess at our institution from to via a retrospective chart review of inpatient records. FromKlebsiella pneumoniae in der Prostata electronic data system was adapted and all patients with acute prostatitis or prostate abscess were included and Klebsiella pneumoniae in der Prostata.

Patients who had KP as the causative organism were selected. Prostate abscess was diagnosed based on clinical, laboratory examination and abdominopelvic computed tomography CT scan. A total of 14 patients were diagnosed with prostate abscess. The mean age was 72 years. Among the 14 patients, KP was the dominant microorganism in 6 patients Among the 6 patients with KP-induced prostate abscess, 4 Case 1 had diabetes mellitus and liver cirrhosis for several years.

He visited our clinic for acute urinary retention, pain between the scrotum and anus, and spiking fever. Any specific sign related with liver abscess was not found. Under the impression of acute prostatitis, relevant laboratory examinations were done. An abdominopelvic CT scan revealed concurrent prostate and liver abscess Fig. Likewise, Case 2 showed concurrent prostate and liver abscess in the abdominopelvic CT scan Fig.

Case 2 also demonstrated signs and symptoms related to lower urinary tract infection. The liver abscess was cured with percutaneous drainage and proper antibiotics. Case 3 had multiple microabscesses in the liver and both kidneys Fig. Case 4 had a prostate and perianal abscess resulting in bacteremia. He complained of ophthalmologic symptoms and was diagnosed with endogenous endophthalmitis, which eventually ended in blindness despite Klebsiella pneumoniae in der Prostata care including vitrectomy.

Except for Case 4, Klebsiella pneumoniae in der Prostata other 5 patients were cured without any complication. A: Diffuse enlargement of prostate and ill-defined low density of prostate peripheral gland. B: About 3. A: Diffuse enlargement of prostate gland and multifocal fluid collection with peripheral rim enhancement.

B: About 2. A: About 1. B: Multiple tiny low density lesion in both kidney suggesting microabscess arrow. Among the 8 patients with prostate abscess wherein KP was not isolated, 1 The clinical presentation of a prostate abscess is usually non-specific and can vary from fever, rectal tenesmus or acute urinary retention; this variation makes it difficult to accurately confirm the diagnosis.

Urine cultures may be negative, and may become positive when Klebsiella pneumoniae in der Prostata abscess opens into the urethra or bladder. Initially, some prostate microabscesses can appear and if they do not respond adequately to antibiotic treatment or if no treatment is started; this situation Klebsiella pneumoniae in der Prostata lead to the onset of prostate abscesses of different dimensions.

Despite the difficulty Klebsiella pneumoniae in der Prostata, it is very important to distinguish between acute prostatitis and prostate abscess, since the therapeutic approach for each is different.

Prompt medical and surgical management of prostatic abscess is Klebsiella pneumoniae in der Prostata to prevent progression to sepsis and death. Half of our patients Klebsiella pneumoniae in der Prostata by KP had concurrent liver abscess.

Before the s, the organism most commonly isolated from liver abscesses was Escherichia colibut in Taiwan and Korea there has been a shift to KP, which is now highly endemic and the major cause of community-acquired pyogenic infections. Authors hypothesized that primary pyogenic liver abscess with KP, although rare, is more common that primary prostate abscess with KP.

Our patients, however, visited the urology clinic due to their lower urinary tract symptoms and fever, and the liver abscess was detected after performing the abdominopelvic CT scan.

Endogenous endophthalmitis is a sight-threatening ophthalmic emergency that requires vitrectomy unless prompt treatment is undertaken. It is usually caused by hematogenous spread of an infection from a distant endogenous focus, mostly from the liver. We treated a patient with endogenous endophthalmitis who also had KP-induced prostate and peri-anal abscesses. Clinicians should entertain the possibility of endogenous endophthalmitis if a patient with a urologic disease, such as a prostate abscess, complains of opthalmo-logic symptoms.

This metastatic phenomenon can be related to the virulence of KP. A single intraperitoneal injection of human neutrophils containing phagocytosed KP lead to Klebsiella pneumoniae in der Prostata formation in multiple sites in mice.

This study reported the clinical features of KP-induced prostate abscess based on a small number of patients, which is the main limitation of our study. So far, most of the available data on prostatic abscess are from case reports. We believe Klebsiella pneumoniae in der Prostata if the causative organism of a prostate abscess was KP, more workup would be needed to rule out the presence of abscess in another organ, especially in the liver. An abdominopelvic CT scan would be a proper imaging modality for this purpose.

Competing interests: Dr. Kim, Dr. Yang, and Dr. Kim declare no competing financial or personal interests. This paper has been peer-reviewed. National Center for Biotechnology InformationU. Can Urol Assoc J. Published online Nov Author information Copyright and License information Disclaimer.

Correspondence: Dr. This article has been corrected. See Can Urol Assoc J. This article has been cited by other articles in PMC. Abstract Introducton: Klebsiella pneumonia KP is related to a metastatic phenomenon from the originally affected primary organ. Methods: A total of 14 patients were diagnosed with prostate abscess based on clinical, laboratory examination and abdominopelvic computed tomography CT scan from to Results: Among these 14 patients, KP was the dominant causative microorganism in 6 patients Conclusions: We report on the clinical features of KP-induced prostate abscess based on a small number of patients, which is the main limitation of our study.

Introduction Prostate abscess is rare Klebsiella pneumoniae in der Prostata due to the development of broad-spectrum antibiotics which have dramatically reduced its incidence. Methods After obtaining institutional review board approval, we examined all cases of prostate abscess at our institution from to via a retrospective chart review of inpatient records.

Results A total of 14 Klebsiella pneumoniae in der Prostata were diagnosed with prostate abscess. Open in a separate window. Table 1. Characteristics of Klebsiella pneumonia-induced prostate abscess. Discussion The clinical presentation of a prostate abscess is usually non-specific and can vary from fever, rectal tenesmus or acute urinary retention; this variation makes it difficult to accurately confirm the diagnosis.

Conclusion Among the 6 patients with KP-induced prostate abscess, 4 Footnotes Competing interests: Dr. References 1. Percutaneous drainage of prostatic abscess: Case report and literature review. Urol Int. Prostatic abscess caused by community-acquired methicillin-resistant Staphylococcus aureus.

Int J Urol. Prostatic abscess: Diagnosis and treatment. J Urol. Treatment of prostatic abscess: Value of transrectal ultrasonographically guided needle aspiration. J Ultrasound Med. Prostatic abscess in the antibiotic era. Rev Infect Dis. Diagnosis and treatment of prostatic abscess. Int Braz J Urol. Prostatic abscess in southern Taiwan: Another invasive infection caused predominantly by Klebsiella pneumoniae. J Microbiol Immunol Infect.