Abstract

Sunil Naik and Yildiz Kemal

Prostatic abscess caused by methicillin resistant Staphylococcus aureus (MRSA) is rare with few previously reported cases. This appears to be the first identifiable report of a healthy, immunocompetent individual developing a community acquired prostatic abscess. A 35 year old male soldier presented to the emergency room complaining of chills, malaise, pelvic pain, tenesmus, dysuria and bloody urine. On admission, he was found to have a high grade fever, abdominal pain, and leukocytosis. He was started on vancomycin. Computed tomography (CT) scan of the abdomen and pelvis revealed fluid-filled sacs inside his prostate, consistent with abscesses. Subsequently, a transurethral prostatic resection was performed with an incision and drainage revealing a MRSA prostatic abscess. Repeat CT of the abdomen/pelvis after six weeks of treatment showed a decrease in the size and number of prostatic abscesses. MRSA prostatic abscesses have been documented in the medical literature primarily of immunocompromised individuals with diabetes mellitus, human immunodeficiency virus (HIV), or acquired immunodeficiency syndrome (AIDS), or preceded by MRSA pneumonia, and not of healthy people. The treatment strategy of a prostatic MRSA abscess is similar to that of skin MRSA abscess with incision and drainage of the abscess and three to six weeks of antibiotics, depending on patient tolerance.