Prostatic Abscess Presenting as Penile Discharge: A Case Report.

Introduction: While prostatic abscess formation is often mitigated by initiating antibiotics for prostatitis, early recognition and treatment are important to avoid risk of sepsis and death.

Case presentation: A 79-year-old male presented with milky-white penile discharge during bowel movements. He had no fever, dysuria, or perineal pain. The discharge culture grew multidrug resistant Escherichia coli. Computed tomography of abdomen/pelvis showed a heterogenous, enlarged prostate leading to diagnosis of a prostatic abscess. The abscess was treated successfully with cystourethroscopy, transurethral unroofing, and a course of intravenous ertapenem.

Discussion: Previous research shows patients with prostatic abscesses present with perineal pain, dysuria, and fever. This case demonstrates the importance of considering a prostatic abscess in a patient with penile discharge alone.

Conclusions: We report a unique presentation of prostate abscess to educate and improve clinical suspicion of a rare, yet potentially fatal urological complication.