Prostatic abscess in a pediatric patient with chronic granulomatous disease: report of a unique case and review of the literature

Abstract

Chronic granulomatous disease (CGD) is a rare hereditary disease in which phagocytes have difficulty forming the superoxide radical required to kill certain pathogens. Individuals with CGD are susceptible to a specific set of infections and granulomatous lesions. We present the case of a 15-year-old boy with X-linked CGD who presented with unremitting cough and fevers. He had a left-sided pneumonia that persisted despite home intravenous antibiotics. He was admitted to an outside facility for bronchoalveolar lavage to obtain cultures and polymerase chain reaction. Computed tomography of chest, abdomen, and pelvis was done for baseline evaluation of extent of disease. Computed tomography revealed a fluid collection in the prostatic fossa, later determined to be a prostatic abscess. To our knowledge, this is the first reported case of a prostatic abscess in a pediatric patient with CGD.

Figure 1

CT of abdomen done at our institution, post transrectal guided needle aspiration (at outside institution). Shows prostatic fluid abscess, about 3cm in size.

Figure 2

H&E stain at 10× magnification showing necrotizing granulomatous inflammation in the prostate. A- Rim of granulomatous tissue, B- Necrosis

Figure 3

CT of abdomen 2 weeks post TUR of prostatic abscess, showing marked decrease in prostate lesion and disappearance of low attenuation lesion consistent with resolving abscess.