A 55-year-old heart-transplant recipient with a tender, enlarge prostate gland

Infection caused by the fungus Cryptococcus (C.) neoformans may result in a prostatic abscess. A prostatic abscess is the collection of pus within tissues of the prostate gland. A 55-year-old man was hospitalized because of a persistent urinary tract infection. He had painful urinations, urinary frequency and urinary hesitancy and he developed fatigue and nausea. He had a history of long-term use of suppressive therapy and was taking prednisone, cyclosporine, azathioprine, ampicillin, ranitidine, nicardipine, quinine sulfate and furosemide. On physical examination, his prostate was enlarged, irregular, slightly tender and draining pus. An ultrasonographic study of the prostate revealed a mass in the right lobe. Examination of prostate tissue removed during surgical resection of the gland showed severe inflammation and a blood sample showed evidence of C. neoformans infection. He improved greatly after the operation and with fluconazole therapy.