A case of cryptococcal prostatic abscess in a 65-year-old Chinese man with immunosuppression from treatment of myasthenia gravis is presented. The patient was diagnosed to have cryptococcaemia when he presented with fever and urinary symptoms. Further investigations confirmed cryptococcal meningitis and imaging studies showed a hypodense lesion in the prostate. This proved to be an abscess and it was deroofed transurethrally. Histology of the prostatic tissue revealed the presence of Cryptococcus. The prostate can be a site of persistent cryptococcal infection and may take the form of an abscess. It should be drained transurethrally to prevent relapse.
Cryptococcosis is a well-recognised infection in immunocompromised patients, although its prevalence varies with the type of immune defect. We report a patient with myasthenia gravis (MG) on steroid therapy and non-insulin dependent diabetes mellitus (NIDDM) who developed cryptococcal meningitis and in whom a search for a persistent focus by means of transrectal ultrasonography and computerized tomographic scanning revealed a prostatic abscess that was drained successfully by transurethral resection.
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