Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis
A 50-year-old male presented with acute urinary retention. He also had a history of cough, haemoptysis, exertional dyspnoea, loss of appetite, generalised weakness and left-ear discharge of 1-month duration. Prior episode of acute urinary retention had occurred 2 months ago; diagnostic evaluation re...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Clinical and Scientific Research |
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| Online Access: | http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=5;spage=5;epage=8;aulast=Bhargav |
| _version_ | 1797998878891442176 |
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| author | K M Bhargav C V S Manasa G Sindhu Alladi Mohan A K Chowhan K Sirisha |
| author_facet | K M Bhargav C V S Manasa G Sindhu Alladi Mohan A K Chowhan K Sirisha |
| author_sort | K M Bhargav |
| collection | DOAJ |
| description | A 50-year-old male presented with acute urinary retention. He also had a history of cough, haemoptysis, exertional dyspnoea, loss of appetite, generalised weakness and left-ear discharge of 1-month duration. Prior episode of acute urinary retention had occurred 2 months ago; diagnostic evaluation revealed prostate abscess, and he had received treatment elsewhere for the same. He also had a history of hypertension. Physical examination revealed fever, pallor, bilateral parotid enlargement and left-ear serous discharge. Clinical examination, imaging of chest revealed consolidation with cavitation on the left side, bilateral pleural effusion. Laboratory testing revealed normocytic normochromic anaemia (haemoglobin 6.6 g/dL); neutrophilic leucocytosis (total leucocyte count 13,100 cells/mm3; polymorphs 87%); raised erythrocyte sedimentation rate (110 mm at the end of the first hour); elevated serum creatinine (2.69 mg/dL) and an active urine sediment. Flexible fibreoptic bronchoscopy showed alveolar haemorrhages. Bronchoalveolar lavage fluid Xpert MTB/RIF testing, cytopathology were negative. Computed tomography-guided biopsy from the lesion was suggestive of granulomatous vasculitis. Cytoplasmic antineutrophil cytoplasmic antibodies (C-ANCA) tested positive. The patient was diagnosed to have granulomatosis with polyangitis (GPA). As arterial hypoxaemia was evident, tracheal intubation and mechanical ventilatory support were initiated. Renal replacement therapy, intravenous (iv) methyl prednisolone and cyclophosphamide pulse therapy and five sessions of plasmapheresis were administered. As remission could not be achieved, iv rituximab was started. On the 36th day of admission, the patient developed septic shock and died. The present case documents the uncommon association of GPA with prostate abscess, acute urinary retention. |
| first_indexed | 2024-04-11T10:55:45Z |
| format | Article |
| id | doaj.art-cd0385d85cac437b8b4656c22ead6d1b |
| institution | Directory Open Access Journal |
| issn | 2277-5706 2277-8357 |
| language | English |
| last_indexed | 2024-04-11T10:55:45Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Clinical and Scientific Research |
| spelling | doaj.art-cd0385d85cac437b8b4656c22ead6d1b2022-12-22T04:28:46ZengWolters Kluwer Medknow PublicationsJournal of Clinical and Scientific Research2277-57062277-83572022-01-011155810.4103/JCSR.JCSR_16_20Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitisK M BhargavC V S ManasaG SindhuAlladi MohanA K ChowhanK SirishaA 50-year-old male presented with acute urinary retention. He also had a history of cough, haemoptysis, exertional dyspnoea, loss of appetite, generalised weakness and left-ear discharge of 1-month duration. Prior episode of acute urinary retention had occurred 2 months ago; diagnostic evaluation revealed prostate abscess, and he had received treatment elsewhere for the same. He also had a history of hypertension. Physical examination revealed fever, pallor, bilateral parotid enlargement and left-ear serous discharge. Clinical examination, imaging of chest revealed consolidation with cavitation on the left side, bilateral pleural effusion. Laboratory testing revealed normocytic normochromic anaemia (haemoglobin 6.6 g/dL); neutrophilic leucocytosis (total leucocyte count 13,100 cells/mm3; polymorphs 87%); raised erythrocyte sedimentation rate (110 mm at the end of the first hour); elevated serum creatinine (2.69 mg/dL) and an active urine sediment. Flexible fibreoptic bronchoscopy showed alveolar haemorrhages. Bronchoalveolar lavage fluid Xpert MTB/RIF testing, cytopathology were negative. Computed tomography-guided biopsy from the lesion was suggestive of granulomatous vasculitis. Cytoplasmic antineutrophil cytoplasmic antibodies (C-ANCA) tested positive. The patient was diagnosed to have granulomatosis with polyangitis (GPA). As arterial hypoxaemia was evident, tracheal intubation and mechanical ventilatory support were initiated. Renal replacement therapy, intravenous (iv) methyl prednisolone and cyclophosphamide pulse therapy and five sessions of plasmapheresis were administered. As remission could not be achieved, iv rituximab was started. On the 36th day of admission, the patient developed septic shock and died. The present case documents the uncommon association of GPA with prostate abscess, acute urinary retention.http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=5;spage=5;epage=8;aulast=Bhargavacute urinary retentiongranulomatosis with polyangitisprostatewegener's granulomatosis abscess |
| spellingShingle | K M Bhargav C V S Manasa G Sindhu Alladi Mohan A K Chowhan K Sirisha Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis Journal of Clinical and Scientific Research acute urinary retention granulomatosis with polyangitis prostate wegener's granulomatosis abscess |
| title | Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| title_full | Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| title_fullStr | Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| title_full_unstemmed | Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| title_short | Prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| title_sort | prostate abscess with acute urinary retention as the initial presentation of granulomatosis with polyangitis |
| topic | acute urinary retention granulomatosis with polyangitis prostate wegener's granulomatosis abscess |
| url | http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2022;volume=11;issue=5;spage=5;epage=8;aulast=Bhargav |
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