Primary Prostatic Melioidosis Manifesting as Multiple Abscesses with Urinary Retention

Primary prostatic melioidosis is an uncommon manifestation of Burkholderia pseudomallei infection, often underdiagnosed in endemic regions. We describe a 43-year-old male presenting with progressive lower urinary tract symptoms and acute urinary retention. Imaging demonstrated a markedly enlarged prostate with multiple multiloculated abscesses confined to the gland. Culture of aspirated pus yielded B. pseudomallei and Pseudomonas aeruginosa. The patient was successfully managed with transrectal ultrasound-guided aspiration, a four-week course of intravenous meropenem with oral co-trimoxazole, followed by three months of oral co-trimoxazole eradication therapy. This case highlights the importance of considering melioidosis in the differential diagnosis of prostatic abscesses, particularly in endemic regions.