Bilateral seminal vesicle abscesses
Journal
International Journal of Infectious Diseases
Journal Volume
13
Journal Issue
1
Pages
e37-e38
Date Issued
2009
Author(s)
Abstract
A 44-year-old unmarried man with chronic hepatitis B presented at the emergency room with a 10-day history of severe dysuria, and urinary frequency and hesitancy. He also suffered from decreased appetite and weight loss of 15 kg during a one-year period. No fever, flank pain or urethral discharge was present. His blood urea nitrogen concentration was 54.2 mg/dl and the serum creatinine concentration was 2.1 mg/dl. Laboratory data revealed an elevated WBC count (35.31 ×103/ml) and blood sugar (645 mg/dl), pyuria (WBC 50–80/HPF), and positive urine sugar and ketone. Biochemistry data showed a high HbA1C of 15.3%. Computed tomography of the abdomen and pelvis disclosed two hypodense lesions (left side: 3.5 cm; right side: 3.3 cm), with marginal enhancement at bilateral seminal vesicles (Figure 1). Physical examination revealed no flank knocking tenderness or signs of orchitis; digital rectal examination revealed tenderness of palpable seminal vesicles with heat. Cultures of urine and blood grew Staphylococcus aureus, and antimicrobial susceptibility testing revealed that the isolate was susceptible to oxacillin, vancomycin, gentamicin, erythromycin, teicoplanin, cotrimoxazole, clindamycin, minocycline and fusidic acid. The patient responded well to treatment and was afebrile within 72 hours of starting therapy, so no subsequent surgical drainage was performed. The patient received parenteral antimicrobial therapy with ciprofloxacin initially and was then switched to oxacillin, in accordance with antimicrobial susceptibility testing. Antibiotic treatment was continued for 28 days and the patient was sent home 30 days after admission with a serum creatinine concentration of 1.1 mg/dl. Repeat blood cultures were sterile. Management of his diabetes was optimized by nutrition counseling, treatment with oral hypoglycemic drugs, frequent blood glucose monitoring and close follow-up with his internist. Conflict of interest: No conflict of interest to declare.
SDGs
Other Subjects
ciprofloxacin; oxacillin; abscess; adult; antibiotic sensitivity; antibiotic therapy; article; blood culture; case report; clinical feature; computer assisted tomography; human; laboratory test; male; physical examination; seminal vesicle abscess; seminal vesicle disease; Staphylococcus aureus; urine culture
Publisher
Elsevier
Type
note