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Life-threatening meningitis resulting from transrectal prostate biopsy

Zhou-Jun Shen1, Shan-Wen Chen, Hua Wang

  • 1Department of Urology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China. shenzhj@mail.hz.zj.cn

Asian Journal of Andrology
|November 11, 2005
PubMed

Insights

A transrectal prostate biopsy led to Escherichia coli meningitis in a patient despite antibiotic prophylaxis. This case highlights a rare but serious complication following prostate cancer diagnostic procedures.

Area of Science:

  • Urology
  • Infectious Diseases
  • Neurology

Background:

  • Prostate adenocarcinoma diagnosis often involves transrectal ultrasonography (TRUS)-guided biopsies.
  • Antibiotic prophylaxis is standard to prevent infectious complications after prostate biopsies.

Observation:

  • A 75-year-old patient developed fever, anxiety, insomnia, and headache post-biopsy, despite receiving pre- and post-procedure antibiotics (metronidazole and levofloxacin).
  • Blood cultures were negative, but subsequent lumbar puncture revealed Escherichia coli bacterial meningitis.

Findings:

  • The patient's symptoms were indicative of bacterial meningitis.
  • Escherichia coli was identified as the causative pathogen via lumbar puncture.

Implications:

  • This case underscores the potential for serious infectious complications, such as bacterial meningitis, following TRUS-guided prostate biopsies, even with appropriate antibiotic prophylaxis.
  • Highlights the importance of considering meningitis in patients presenting with neurological symptoms post-procedure.
  • Suggests a need for vigilance and potentially revised prophylactic or diagnostic protocols for prostate biopsies.

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