Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature

BMC Infect Dis. 2017 Jul 21;17(1):509. doi: 10.1186/s12879-017-2605-4.

Abstract

Background: Prostatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature.

Case presentative: We present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant.

Conclusion: S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.

Background: Prostatic abscess is a rare complication of acute bacterial prostatitis and is most commonly caused by Enterobacteriaceae. We report on a case of prostatic abscess caused by Staphylococcus aureus and conduct a review of the literature.

Case presentation: We present a case of S. aureus prostatic abscess that was successfully treated with a combination of antibiotic and surgical therapy. The isolate was non–multidrug-resistant, methicillin-resistant Staphylococcus aureus and was genotyped as clonal complex 5, an emerging regional clone that is trimethoprim resistant and Panton-Valentine leukocidin positive. This current case report is the first to describe the use of clindamycin step-down therapy. A literature review identified a further 39 cases of S. aureus prostatic abscesses, of which 26 were methicillin resistant.

Conclusions: S. aureus is an uncommon cause of prostatic abscess. Optimal management includes both antibiotic therapy and surgical drainage. Our use of clindamycin as step-down therapy was guided by its excellent prostatic penetration.

Electronic supplementary material: The online version of this article (doi:10.1186/s12879-017-2605-4) contains supplementary material, which is available to authorized users.

Keywords: MRSA; MSSA; PVL; Prostatic abscess; Prostatic abscesses; ST5-MRSA; Staphylococcus aureus; nmMRSA.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abscess / microbiology
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Toxins / genetics
  • Clindamycin / therapeutic use
  • DNA, Bacterial / genetics
  • DNA, Bacterial / metabolism
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Prostatic Diseases / diagnosis*
  • Prostatic Diseases / drug therapy
  • Prostatic Diseases / microbiology
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics
  • Staphylococcus aureus / isolation & purification
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Bacterial Toxins
  • DNA, Bacterial
  • Clindamycin