Korean J Urogenit Tract Infect Inflamm.  2013 Oct;8(2):129-132. 10.14777/kjutii.2013.8.2.129.

Septic Pulmonary Embolism Secondary to Prostate Abscess

• Moon KB
• Lim GS
• Hwang JS
• Lim CH
• Kim DJ
• Son JH

• KMID: 1502120
• DOI: http://doi.org/10.14777/kjutii.2013.8.2.129

Abstract

A 30-year-old male admitted to our hospital with sudden onset shortness of breath, general weakness, dysuria, frequency, oligouria and fever. Abdominal and chest computed tomography revealed septic pulmonary embolism, multiple thrombi along right common iliac, internal iliac and femoral vein and large size prostatic abscess (right lobe>5 cm, left lobe>3.5 cm). We, therefore, diagnosed septic pulmonary embolism secondary to prostate abscess. Abscess was drained by transurethral resection of prostate with appropriate antibiotics therapy. There were no postoperative complications with complete abscess resolution. Septic pulmonary embolism originated from urinary tract infection is rare. So we present a case report and the review of relevant literatures.

Keyword

Prostate; Abscess; Embolism

MeSH Terms

Abscess*
Adult
Anti-Bacterial Agents
Dyspnea
Dysuria
Embolism
Femoral Vein
Fever
Humans
Male
Postoperative Complications
Prostate*
Pulmonary Embolism*
Thorax
Transurethral Resection of Prostate
Urinary Tract Infections
Anti-Bacterial Agents

Figure

• 

  Fig. 1. Preoperative chest and abdominopelvic computed tomography. (A) Multiple septic pulmonary emboli. (B) Multiple thrombi along right common iliac, internal iliac and femoral vein showing total obstruction of right internal iliac vein. (C) Large size prostate abscess (right lobe >5 cm, left lobe >3.5 cm).

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  Fig. 2. Follow up abdominopelvic computed tomography on postoperative 24th day. Improved state of previous prostate swelling and decreased size of prostate cavity.

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  Fig. 3. Follow up cystoscopy on postoperative 36th day. A large cavitation was seen at the right prostate lobe after prostatic abscess drainage.

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  Fig. 4. Follow up abdominopelvic computed tomography (1 year after operation). Totally improved prostate cavitation.

Reference

1. Cook RJ, Ashton RW, Aughenbaugh GL, Ryu JH. Septic pulmonary embolism: presenting features and clinical course of 14 patients. Chest. 2005; 128:162–6.

2. Moon HJ, Eom KS, Lee JH, Cheon WS, Jung DR, Kim DG, et al. A case of septic embolism after fever, sore throat, and myalgia. Korean J Med. 2006; 70:569–74.

3. Lee HY, Kim NH, Kim JH, Kim DH, Kim YS, Jee YK, et al. A case of septic pulmonary embolism due to pyelonephritis. Korean J Med. 2009; 76:105–9.

4. Uysal A, Datti B, Tapolyai M, Boktor M, Lang C. Septic Emboli with an epidural abscess. Internet J Pulm Med. 2007; 8.

5. Mattar CS, Keith RL, Byrd RP Jr, Roy TM. Septic pulmonary emboli due to periodontal disease. Respir Med. 2006; 100:1470–4.

6. Peng MY, Fan CK, Chang FY. Lemierre's syndrome. J Formos Med Assoc. 2005; 104:764–7.

7. Kim EJ, Park JH, Kim CH, Park JY, Jung TH, Cha SI. A case of lemierre syndrome associated with septic pulmonary emboli. Tuberc Respir Dis. 2005; 58:73–7.

8. Lee SJ, Cha SI, Kim CH, Park JY, Jung TH, Jeon KN, et al. Septic pulmonary embolism in Korea: microbiology, clinicoradiologic features, and treatment outcome. J Infect. 2007; 54:230–4.

9. Oliveira P, Andrade JA, Porto HC, Filho JE, Vinhaes AF. Diagnosis and treatment of prostatic abscess. Int Braz J Urol. 2003; 29:30–4.

10. Miyaki J, Souma S, Narumiya Y, Chiba S, Kugiyama K. A case of septic pulmonary embolism showing the rapid appearance of multiple cavities in both lung fields induced by urinary tract infection. Nihon Kokyuki Gakkai Zasshi. 2006; 44:879–84.