title: [A case of prostate abscess with sepsis, infectious endocarditis and pyogenic spondylitis].
abstract: A 65-year-old man with diabetes mellitus (DM) presented with an indwelling urethral catheter placed for urinary retention by his previous doctor. Thereafter, he had fever, vomiting and general fatigue. His blood examination showed severe inflammatory findings. He was diagnosed with acute prostatitis and immediately admitted to our hospital. Pelvic computerized tomography (CT) showed a prostate abscess. We performed transrectal ultrasonographic-guided puncture of the prostate abscess for drainage and blood culture was tested. Methicillin-sensitive Staphylococcus aureus (MSSA) was cultured from the puncture fluid and blood. We administered antibiotics with strict control of DM. After the prostate abscess improved and the urethral catheter was removed, the patient was systematically examined for potential sepsis-related disease caused by MSSA septic infection. Magnetic resonance imaging (MRI) of the head indicated multiple cerebral infarction, abdominal CT indicated splenetic infarction, ultrasonography of the heart indicated vegetation on the mitral valve and aortic valve, and chest X-ray indicated pulmonary congestion. Furthermore, MRI of the lumbar spine showed a high intensity lesion at the 4th and 5th lumbar spine, indicating pyogenic spondylitis. We diagnosed prostate abscess with sepsis, infectious endocarditis, congestive heart failure and pyogenic spondylitis. Aortic valve replacement, mitral annuloplasty, tricuspid valvuloplasty and ovale hole closure surgeries were performed to treat these conditions.
authors.affiliation: The Department of Urology, Kobe University Graduate School of Medicine, Japan.
authors.forename: Minori
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Fukashi
authors.initials: F
authors.lastname: Yamamichi
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000038:Abscess / Q000150:complications*; D000368:Aged; D004697:Endocarditis, Bacterial / Q000150:complications*; D006801:Humans; D008297:Male; D011469:Prostatic Diseases / Q000150:complications*; D018805:Sepsis / Q000150:complications*; D013166:Spondylitis / Q000150:complications*; D013203:Staphylococcal Infections / Q000150:complications*