Xanthogranulomatous prostatitis presenting as Pseudomonas aeruginosa prostatic abscesses: An uncommon complication after kidney transplantation
Bibliographic record
Abstract
Xanthogranulomatous (XG) prostatitis is a rare form of granulomatous prostatitis characterized by a benign inflammatory process of non-specific etiology that clinically may mimic carcinoma. Few cases have been reported in the English language medical literature, with only four reported cases presenting as prostatic abscesses. A 70-year-old male with type 2 diabetes mellitus and two previous kidney transplants presented with septic shock secondary to Pseudomonas aeruginosa bacteremia 4 days after undergoing a cystoscopy. Despite appropriate antimicrobial therapy, P. aeruginosa persisted in the blood for a total of 7 days. There were no indwelling prosthetic devices, no complicated pyelonephritis, and no endovascular sources of infection. Upon repeat clinical assessment, the patient reported pelvic pain. A digital rectal examination revealed prostatic tenderness and an endorectal ultrasound confirmed multiple prostatic abscesses. An ultrasound-guided transrectal needle aspirate drained scant purulent fluid and cultures grew the same phenotypic strain of P. aeruginosa. For definitive source control, the patient underwent transurethral resection of the prostate with unroofing of prostatic abscesses. The pathological findings were diagnostic of XG prostatitis. Given the rather acute presentation of this case, our hypothesis is that the prior urological instrumentation likely facilitated bacterial translocation and created the ideal environment for the development of pseudomonal prostatic abscesses resulting in XG inflammation and necrosis. XG prostatitis is a rare entity of uncertain etiology that can result in prostatic abscesses, and surgery is required for definitive diagnosis and management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".