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Updated: Jun 12, 2026

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
Published on: September 21, 2015
Post-prostate Biopsy Septic Shock Due to Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli: A Case
Joseph Trainer1, Steven Khosid1, John Wilder1
1Emergency Medicine, St. Barnabas Hospital Health System, Bronx, USA.
None:
Prostate biopsy is a commonly performed urological procedure, yet infectious complications, including sepsis and bacteremia, remain a significant and potentially life-threatening risk. We present a case of a 65-year-old male patient who developed urosepsis with Escherichia coli extended-spectrum beta-lactamase (ESBL)-producing bacteremia following a transrectal prostate biopsy. Despite an initially non-toxic appearance, the patient rapidly deteriorated, requiring vasopressor support and intensive care unit admission. Empiric therapy with vancomycin and ceftriaxone was initiated, and antibiotic coverage was escalated to meropenem upon identification of an ESBL-producing organism. He subsequently recovered and was discharged in stable condition. This case highlights the importance of early recognition of sepsis in post-procedural patients, the rising threat of ESBL-producing organisms in urological infections, and the need for vigilance even when initial presentations appear benign.
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