A Case of Prostatic Abscess and Rectoprostatic Fistula with Pyogenic Vertebral Osteomyelitis Associated with Non-Insulin Dependent Diabetes Mellitus.
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Accession number;99A0515712
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| Title;A Case of Prostatic Abscess and Rectoprostatic Fistula with Pyogenic Vertebral Osteomyelitis Associated with Non-Insulin Dependent Diabetes Mellitus. |
| Author;
TANAKA KEIJI
(The Kitasato Inst., Medical Cent. Hosp.)
KANAMORI AKIRA
(Kitasato Univ., Sch. of Med.)
YAJIMA YOSHITADA
(Kitasato Univ., Sch. of Med.)
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Journal Title;Journal of the Japan Diabetic Society
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Journal Code:Z0279B
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ISSN:0021-437X
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VOL.42;NO.4;PAGE.305-310(1999)
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| Figure&Table&Reference;FIG.4, TBL.1, REF.18 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;A 62-year old man with a 15-year history of untreated diabetes mellitus initially visited another hospital because of miction pain. He was diagnosed with urethritis and treated with antibiotics Pipecacillin Sodium without improvement. He was admitted to our hospital with persistent fever, diabetic ketoacidosis and sepsis caused by Methicillin resistant staphylococcus aureus (MRSA). Diagnostic CT revealed prostatitis, and we subsequently detected sepsis related to prostatitis. On hospital day 7, white pus caused by MRSA was discharged from the anus. Various diagnostic imaging procedures revealed a prostatic abscess and rectoprostatic fistula. Although improvement was obtained by withholding food and administering antibiotics (Amikacin Sulfate), the patient experienced lower back pain, and a blood examination showed an increasd inflammatory reaction on hospital day 28. MRI revealed pyogenic vertebral osteomyelitis. By hospital day 204, all symptoms resolved with a change in antibiotics (Minocycline Hydrochloride). These findings suggest that the lower urinary tract infection, in the present case, may have spread to the vertebra and its surrounding tissue through hematogenous dissemination. In managing such a case, the physician must keep in mind the possibility that the condition may become severe if it involves MRSA. (author abst.) |
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