A rare case of prostatic abscess caused by MRSA in a healthy young male: A case report and literature review

Abstract

Introduction and importance

Prostatic abscess (PA) is a rare urological condition typically associated with predisposing factors such as diabetes, immunosuppression, or prior instrumentation. It is most commonly caused by gram-negative organisms, with methicillin-resistant Staphylococcus aureus (MRSA) being a rare pathogen, even in immunocompromised individuals. Early diagnosis and prompt treatment are important to prevent severe complications.

Case presentation

We report a rare case of a previously healthy 37-year-old male who presented with severe back pain, dysuria, and perineal discomfort persisting for two weeks. Initial evaluation at another facility resulted in a misdiagnosis of urinary tract infection (UTI). At presentation, laboratory tests revealed leukocytosis and elevated C-reactive protein. CT scan showed a large prostatic abscess, measuring of 6 × 7 cm, with necrosis and septations. Blood, urine, and abscess cultures confirmed MRSA. Management involved CT-guided drainage of the abscess and intravenous vancomycin, resulting in complete clinical resolution.

Case discussion

While PA is uncommon, it should be considered in patients with persistent urinary symptoms or back pain unresponsive to standard treatment. MRSA as a causative agent is particularly rare in immunocompetent patients. This case highlights the need for early imaging and culture-directed therapy in atypical presentations.

Conclusion

This report highlights the importance of recognizing prostatic abscess as a differential diagnosis in young, otherwise healthy males with unresolved symptoms. Early intervention and targeted therapy ensure optimal outcomes.