Prostatic Abscess Due to Idiopathic Granulomatous Disease: A Rare Complication of a Chameleon Disorder —Prostatic Abscess Due to Idiopathic Granulomatous Disease  

作　　者：Kamel El-Reshaid Adel Allam Sayed Mohamad Kamel El-Reshaid;Adel Allam;Sayed Mohamad(Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait;Department of Urology, Al Salam Hospital, Kuwait City, Kuwait;Department of Radiology, Al Salam Hospital, Kuwait City, Kuwait)

机构地区：[1]Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait [2]Department of Urology, Al Salam Hospital, Kuwait City, Kuwait [3]Department of Radiology, Al Salam Hospital, Kuwait City, Kuwait

出　　处：《Open Journal of Nephrology》2023年第1期6-12,共7页肾脏病（英文）

摘　　要：Background: Prostatic abscesses are usually diagnosed in the setting of bacterial prostatitis. Rarely, they reveal or complicate granulomatous prostatitis (GP). Four cases of idiopathic xanthogranulomatous GP have been described previously and the present case report is the first of typical idiopathic variety. The case: A 60-year-old man presented with urine retention that was associated with pyuria and massively enlarged prostate. Cystoscopy revealed prostatic abscess (PA) that was opened. Urine and prostatic culture were negative for bacteria. Prostatic biopsy revealed multiple non-caseating granulomata surrounded by lymphocytes, plasma cells yet without foamy histiocytes, parasites and vasculitis. Special stains were negative for vasculitis, fungiand acid-fast organisms. The patient was treated with Solumedrol 1 g intravenously daily for 3 days followed by Prednisone 1 mg/kg/day for 1 month followed by gradual tapering till discontinuation by 3^rd month. Moreover, he had received Mycophenolate mofetil (MMF) 1 g twice/daily. By the end of 2^nd month;he was asymptomatic and without pyuria. Repeat cystourethroscopy and MRI scan of the prostate showed near normal prostate. In Conclusion: Idiopathic GP can present with PA that requires proper drainage and since it is a locally hyperimmune disease with genetic predisposition;MMF therapy will be maintained for a total of 2 years to prevent future disease-relapse.Background: Prostatic abscesses are usually diagnosed in the setting of bacterial prostatitis. Rarely, they reveal or complicate granulomatous prostatitis (GP). Four cases of idiopathic xanthogranulomatous GP have been described previously and the present case report is the first of typical idiopathic variety. The case: A 60-year-old man presented with urine retention that was associated with pyuria and massively enlarged prostate. Cystoscopy revealed prostatic abscess (PA) that was opened. Urine and prostatic culture were negative for bacteria. Prostatic biopsy revealed multiple non-caseating granulomata surrounded by lymphocytes, plasma cells yet without foamy histiocytes, parasites and vasculitis. Special stains were negative for vasculitis, fungiand acid-fast organisms. The patient was treated with Solumedrol 1 g intravenously daily for 3 days followed by Prednisone 1 mg/kg/day for 1 month followed by gradual tapering till discontinuation by 3^rd month. Moreover, he had received Mycophenolate mofetil (MMF) 1 g twice/daily. By the end of 2^nd month;he was asymptomatic and without pyuria. Repeat cystourethroscopy and MRI scan of the prostate showed near normal prostate. In Conclusion: Idiopathic GP can present with PA that requires proper drainage and since it is a locally hyperimmune disease with genetic predisposition;MMF therapy will be maintained for a total of 2 years to prevent future disease-relapse.

关 键 词：Cystourethroscopy Granulomatous Prostatitis MRI Mycophenolate Mofetil Prostatic Abscess 

分 类 号：R69[医药卫生—泌尿科学]