A Case of an Elderly Type 2 Diabetic Patient Who Developed the Prostatic Abscess Followed by <i>Staphylococcus aureus</i> Bacteremia, Multiple Muscle Abscesses and Septic Arthritis

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  • 前立腺膿瘍に黄色ブドウ球菌菌血症，多発性膿瘍を続発した高齢2型糖尿病の1例

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<p>An 89-year-old man was admitted to our hospital due to poorly controlled type 2 diabetes, a high white blood cell count, and an elevated C reactive protein level. Computed tomography (CT) with contrast agent revealed a huge prostatic abscess, which was considered refractory to conservative therapy, but the patient and his family refused invasive treatment. Methicillin-sensitive Staphylococcus aureus was isolated in both blood and urine cultures on admission, and the intravenous administration of cefazolin was started. On Day 3 of hospitalization, reddening of the skin and swelling near the left sternoclavicular joint emerged. Magnetic resonance imaging showed arthritis of the left sternoclavicular joint spreading to the superior mediastinum and multiple abscesses of the left greater pectoral muscle. Prolonged antibiotics treatment was continued under the diagnosis of septic arthritis, and his general condition and the skin inflammation findings ameliorated. Although the white blood cell count and C reactive protein levels gradually decreased, follow-up CT on Day 27 of hospitalization revealed a new massive abscess at the left erector spinae muscles. He ultimately needed antibiotics treatment for 14 weeks until all the abscesses had disappeared on imaging.</p>

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