A Case of Burkholderia Prostatitis in a Patient with Chronic Granulomatous Disease
- PDF / 1,710,786 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 102 Downloads / 163 Views
LETTER TO EDITOR
A Case of Burkholderia Prostatitis in a Patient with Chronic Granulomatous Disease Sameer Bahal 1
&
Nisha Verma 1 & Susan Tadros 1 & David M. Lowe 1 & Siobhan O. Burns 1,2
Received: 23 May 2020 / Accepted: 20 July 2020 / Published online: 16 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
To the Editor, Chronic Granulomatous Disease (CGD) is a rare, hereditary phagocytic immunodeficiency secondary to a defect in the NADPH (nicotinamide adenine dinucleotide phosphate) oxidase pathway leading to impaired superoxide formation [1]. The X-linked form is caused by a mutation in the CYBB gene. CGD patients are particularly susceptible to catalase positive bacterial and fungal infections with the lungs, skin, lymph nodes and liver being the most common sites of infection. Inflammatory complications are an additional source of morbidity with granulomatous inflammation commonly affecting the gastrointestinal and urinary tracts, skin and lungs. Antimicrobial, antifungal and steroid therapies remain the mainstay of conservative treatment for patients who have not undergone curative hematopoietic stem cell transplant or gene therapy. Here, we report a case of prostatitis affecting a 34-year-old man who had been diagnosed with X-linked CGD in childhood. In the 4 weeks before the patient presented to our centre, he had had two short inpatient admissions to his local hospital with shortness of breath, cough and intermittent fevers. A CT scan of the chest and abdomen did not reveal a source of infection, and two nasopharyngeal swabs for SARS-CoV-2 infection were negative. No sputum sample for bacterial culture was obtained, but his symptoms partially improved with a course of co-amoxiclav. Towards the end of this illness, he developed pain affecting his back and abdomen. Less than a week later, the patient was readmitted to his local hospital with Sameer Bahal and Nisha Verma are joint first author * Sameer Bahal [email protected] 1
Department of Immunology, Royal Free Hospital, Pond Street, Hampstead, London, UK
2
Institute for Immunity and Transplantation, University College London, Pond Street, Hampstead, London, UK
a 2-day history of fevers measuring up to 40 °C, suprapubic and lower back pain, headaches and dysuria. There was no history of previous urinary tract infections, recent foreign travel or suspicion of a sexually transmitted cause. Of note, the patient had a past medical history of left testicular teratoma aged 24 treated with orchiectomy and 4 months of chemotherapy. On the first day of admission, he did not pass urine, and urinary retention was suspected. Catheterization was attempted but abandoned due to severe pain. Elevated white cells were noted on urinalysis (143 × 106/L (reference range 1–45 × 106/L)); a provisional diagnosis of a urinary tract infection was made, and intravenous antibiotics were commenced. After several days, he was transferred to our unit for continued management. C-reactive protein (154 mg/L, reference range 0–5) and prostate specifi
Data Loading...
