Prostatic Abscess due to Burkholderia pseudomallei : Facilitating Diagnosis to Optimize Management

Prostatic involvement is common in men with melioidosis. Indeed, some clinicians recommend radiological screening of all male patients as an undrained prostatic abscess may result in relapse of this potentially fatal disease. However, sophisticated medical imaging is frequently unavailable in the re...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2018-01, Vol.98 (1), p.227-230
Main Authors: Kozlowska, Jowita, Smith, Simon, Roberts, Jay, Pridgeon, Simon, Hanson, Josh
Format: Article
Language:English
Subjects:
Abscess - diagnosis
Abscess - diagnostic imaging
Abscess - microbiology
Adult
Aged
Burkholderia pseudomallei
Humans
Leukocyte Count
Male
Melioidosis - diagnosis
Melioidosis - diagnostic imaging
Middle Aged
Prostate
Prostate - diagnostic imaging
Prostate - microbiology
Prostatic Diseases - diagnosis
Prostatic Diseases - diagnostic imaging
Prostatic Diseases - microbiology
Radiography
Tomography, X-Ray Computed
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Description
Summary:Prostatic involvement is common in men with melioidosis. Indeed, some clinicians recommend radiological screening of all male patients as an undrained prostatic abscess may result in relapse of this potentially fatal disease. However, sophisticated medical imaging is frequently unavailable in the remote and resource-poor locations where patients are managed. In this retrospective study from Queensland, Australia, 22/144 (15%) men with melioidosis had a radiologically confirmed prostatic abscess. The absence of urinary symptoms had a negative predictive value (NPV) (95% confidence interval [CI]) for prostatic abscess of 96% (90-99%), whereas a urinary leukocyte count of < 50 × 10 /L had an NPV (95% CI) of 100% (94-100%). A simple clinical history and basic laboratory investigations appear to exclude significant prostatic involvement relatively reliably and might be used to identify patients in whom radiological evaluation of the prostate is unnecessary. This may be particularly helpful in locations where radiological support is limited.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.17-0633