Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetes mellitus associated with urinary tract infections and ureteral obstruction can be predisposing factors leading to emphysematous pyelonephritis. Fever, flank pains, and a palpable renal mass, associated with dehydration and hyperglycemia, were the most frequent presenting symptoms associated with emphysematous pyelonephritis. Computerized tomography (CT) scan is the best method to identify a renal or perirenal abscess and its ramifications. Intravenous antibiotic therapy is determined by blood and urine cultures. Mortality was zero in patients treated by nephrectomy. One patient who had incision and drainage of a renal abscess died of sepsis, and 1 patient died of sepsis following incision and drainage of a prostatic abscess. Patients with cystitis emphysematosa require antibiotic therapy and relief of bladder outlet obstruction. Prostatic abscess is best treated by perineal incision and drainage. Periurethral scrotal abscesses should be incised, drained, and the overlying necrotic skin debrided. Early diagnosis and aggressive medical and surgical management of gas-forming infections of the genitourinary tract are vital.
 ...
PMID:Gas-forming infections in genitourinary tract. 155 45

We report an unusual case of an emphysematous prostatic abscess. Prostatic abscess is a difficult clinical diagnosis associated with lower urinary tract symptomatology and frequently diabetes mellitus. Computerized axial tomography and transrectal or transurethral ultrasonography can assist in making a specific diagnosis. Definitive treatment is complete surgical drainage, which is achieved by transurethral resection of the prostate. Wide spectrum, adjuvant antibiotic therapy should be given to assure coverage of anaerobic bacteria.
 ...
PMID:Emphysematous prostatic abscess: diagnosis and treatment. 683 15

Prostatic abscess is an unusual occurrence in the era of modern antibiotics. We report a rare case of emphysematous prostatic abscess owing to Klebsiella pneumoniae in a 45-year-old man with a 10-year history of alcoholism and a 6-year history of diabetes mellitus. Prostatic abscess is a difficult clinical diagnosis without specific symptoms and signs. Computerized tomography can assist in making the diagnosis of emphysematous prostatic abscess. Definitive treatment is complete surgical drainage and the use of effective antibiotics.
 ...
PMID:Emphysematous prostatic abscess due to Klebsiella pneumoniae. 976 96

Prostatic abscess, though rarely encountered since the introduction of broad-spectrum antibiotics, can cause significant morbidity and mortality. We retrospectively reviewed 17 cases of prostatic abscess treated during an 11-year period at 2 medical centers in southern Taiwan. Most of these patients were elderly (mean age, 59 years) with diabetes mellitus (10 cases, 59%) or hepatic cirrhosis (5 cases, 29%). Fourteen (82%) of the 17 patients were febrile, with chills occurring in about a half of these. Of the symptoms and signs referable to the lower urinary tract, dysuria (71%) was the most common complaint. Pain was usually localized in the suprapubic (35%) or perineal (18%) area. The common findings of digital rectal examination were prostatic enlargement (77%) and fluctuation (23%). Prostatic abscess was impressed from the findings of hypoechoic area with thick walls on transrectal ultrasound or an enlarged gland with fluid-density collections on computed tomography. All causative pathogens were gram-negative bacilli, including Klebsiella pneumoniae (10 cases), Escherichia coli (2), and Pseudomonas aeruginosa (1). Various measures were undertaken to allow drainage, including transurethral incision or resection of the prostate, open perineal incision, laparotomy, and transrectal ultrasound- or computed tomography-guided needle aspiration. In conclusion, K. pneumoniae was the predominant pathogen of prostatic abscess, and was frequently identified as the causative pathogen in patients with diabetes mellitus. Diagnosis of prostatic abscess based merely on symptomatology is implausible, and image studies, such as transrectal ultrasound or computed tomography scan, are warranted. Optimal management includes adequate drainage of abscess and antimicrobial therapy.
 ...
PMID:Prostatic abscess in southern Taiwan: another invasive infection caused predominantly by Klebsiella pneumoniae. 1274 30

Prostatic abscess is an uncommon condition and clinical diagnosis is difficult. The classical symptoms and signs of prostatic abscess are variable and nonspecific. Here, we report a rare case of emphysematous prostatic abscess due to candidiasis in a 68-year-old man with diabetes and liver cirrhosis. The diagnosis was confirmed by pelvic computed tomography (CT) and successfully treated by antibiotics and CT-guided percutaneous abscess drainage. This case highlights the importance of early and accurate diagnosis of emphysematous prostatic abscess followed by appropriate treatment.
 ...
PMID:Emphysematous prostatic abscess due to candidiasis: a case report. 1828 Dec 27

Prostatic abscess is a rarely described condition and is commonly caused by gram-negative organisms such as enterobacteria. However, as the prevalence of methicillin resistant Staphylococcus aureus (MRSA) increases in the community, unusual infections due to this organism have been recently published. In this report, we describe a patient with diabetes mellitus type 2, who presents with diabetic ketoacidosis-later found to be due to a prostatic abscess from which MRSA was cultured.
...
PMID:A Rare Presentation of Community Acquired Methicillin Resistant Staphylococcus aureus. 2445 92

A 58-year-old male with alcoholic liver cirrhosis and a 58-year-old male with diabetes mellitus presented with high fever and urinary retention. Prostatic abscess was diagnosed by a computed tomography scan, which showed fluid collection in the prostate in both patients. Despite systematic antibiotic therapies, urinary retention persisted even after fever diminished. They underwent prostatic abscess drainage by transurethral resection (TUR). Urinary retention was released, and the recurrence of prostatic abscess has not been observed after TUR.
 ...
PMID:[Two Cases of Urinary Retention with Prostatic Abscess Drained by Transurethral Resection]. 2810 60

Background. Prostatic abscess is rare and mainly affects immunocompromised individuals, classically presenting with both systemic and lower urinary tract symptoms. Our case is unique as the patient presented with an exceptionally long duration of symptoms prior to seeing a health-care provider, had no systemic symptoms, and was managed via a multidisciplinary approach. Case Presentation. We present a case of a 70-year-old man with type-two diabetes who endured two months of lower urinary tract symptoms and constipation without systemic symptoms prior to seeking medical attention. He had a positive urinalysis and culture and was initially thought to have a urinary tract infection; however, computed tomography scan revealed a large, complex, and multiloculated prostatic abscess. Multidisciplinary drainage of the abscess was performed by interventional radiology and urology. A postoperative Foley catheter was left in place, and the patient recovered without complications. Discussion. Prostatic abscess is uncommon and presents almost exclusively in patients with immunocompromising conditions such as diabetes. Prior to the advent of antibiotics, the major causes were gonorrheal and Staphylococcus aureus infections, but with the advent of antibiotics, microbial culprits have shifted to gram-negative organisms. Patients typically present with lower urinary tract symptoms, perineal or lower back pain, and systemic symptoms. Management often consists of intravenous antibiotics and surgical drainage either by transrectal ultrasound-guided needle aspiration, or transurethral deroofing of the prostate. Our case highlights the following: (a) the importance of a high index of suspicion for a prostatic abscess in an immunocompromised patient with persistent leukocytosis and perineal pain after treatment with antibiotics and (b) the potential for an early multidisciplinary approach to draining extensive, loculated prostatic abscesses.
 ...
PMID:Extensive Prostatic Abscess in an Elderly Patient Requiring Multidisciplinary Drainage. 3256 52