992 Prostatic Abscess in an Immunocompetent Adolescent: A Rare Case Report

Background Prostatic abscess (PA) is uncommon, typically seen in the middle age population. PA in adolescents is extremely rare. Risks factors include diabetes mellitus, immunodeficiency, recurrent urinary tract infection and urological procedure. The diagnosis of PA is challenging due to its vague and non-specific symptoms. It is recommended that a PA larger than 1 cm is treated with surgically drainage and adequate antibiotics Case Presentation We present a case of PA in a 19-year-old Afro Caribbean male. He presented with swinging pyrexia, generalised abdominal and rectal pain. He denied urinary symptoms. He had no significant past medical history. Digital rectal examination yielded pain on palpation of prostate. Immunodeficiency history and screening were negative. CT showed a multilocular prostatic abscess measuring 6.0 x 3.4 x 4.9 cm. Blood and urine culture were negative. The patient was treated initially with ciprofloxacin and gentamicin for a week. Then later discharged with six weeks of ciprofloxacin. MRI was performed after 3 months which showed only post-inflammatory changes in the prostate gland but no residual PA Conclusions We were able to demonstrate treatment success in a large PA in an adolescent without surgical drainage which is usually the mainstay treatment. The early diagnosis and treatment based on patient selection in this case remain pivotal in development of a treatment algorithm and improving patient outcomes.