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

Jowita Kozlowska; Simon Smith; Jay Roberts; Simon Pridgeon; Josh Hanson

doi:10.4269/ajtmh.17-0633

ISSN: 0002-9637
E-ISSN: 1476-1645

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

Jowita Kozlowska¹, Simon Smith^1,2, Jay Roberts¹, Simon Pridgeon¹, Josh Hanson^1,3,4
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Affiliations: ¹ Cairns Hospital, Cairns, Queensland, Australia; ² James Cook University, Cairns, Queensland, Australia; ³ The Kirby Institute, University of New South Wales, Sydney, Australia; ⁴ Menzies School of Health Research, Darwin, Australia

*Address correspondence to Josh Hanson, The Kirby Institute, Wallace Wurth Building, High Street, Kensington NSW 2052, Australia. E-mail: jhanson@kirby.unsw.edu.au
fn1Authors’ addresses: Jowita Kozlowska and Simon Smith, Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia, E-mails: jowitakozl@gmail.com and simon.smith2@health.qld.gov.au. Simon Smith, Department of Medicine, Cairns Hospital, The Esplanade, Cairns, Queensland, Australia, E-mail: simon.smith2@health.qld.gov.au. Jay Roberts and Simon Pridgeon, Department of Urology, Cairns Hospital, Cairns, Queensland, Australia, E-mails: jay.roberts@health.qld.gov.au and simon.pridgeon@health.qld.gov.au. Josh Hanson, The Director’s Unit, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia, and Cairns Hospital, General Medicine, Cairns, Queensland, Australia, E-mail: jhanson@kirby.unsw.edu.au.
Publisher: The American Society of Tropical Medicine and Hygiene
Source: The American Journal of Tropical Medicine and Hygiene, Volume 98, Issue 1, 10 Jan 2018, p. 227 - 230
DOI: https://doi.org/10.4269/ajtmh.17-0633

Abstract

Abstract.

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 × 106/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.

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

The American Journal of Tropical Medicine and Hygiene 98, 227 (2018); https://doi.org/10.4269/ajtmh.17-0633

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Received : 09 Aug 2017
Accepted : 02 Sep 2017
Published online : 30 Oct 2017

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

Abstract

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