A clinical case: sepsis post prostate biopsy puncture
DOI:
https://doi.org/10.47187/cssn.Vol14.IssEd.Esp.230Keywords:
prostate cancer, transrectal biopsy, septic shockAbstract
Introduction: Prostate cancer is generally diagnosed through a rectal examination, although sometimes the support of complementary tests is necessary, such as a prostate biopsy. The most widely biopsy used around the world is transrectal biopsy and it is used to obtain samples of prostate tissue in patients with suspected prostate cancer. This procedure has a post-procedure sepsis rate of 0.3% to 0.8%, with a 1.1% hospitalization rate due to post-biopsy infections. Case presentation: A 71-year-old patient with a history of prostatic hyperplasia, attended to a private hospital in Quito city to undergo a transrectal prostate biopsy on an outpatient basis, stable in recovery and later discharged. Two days after the intervention, the patient presented clinical symptoms and was admitted to the emergency area, he was unstable and was admitted to the intensive care area with a diagnosis of septic shock plus multiple organ dysfunction, for which antimicrobial therapy was started with meropenem. However, the patient did not have a favorable evolution, so linezolid was added on the fourth day, evidencing a decrease in the white series and compensation of the patient, who stabilized after 12 days and was transferred to hospitalization. Conclusion: Transrectal biopsy is an invasive method in which septic complication is frequent; nevertheless, if they are not treated with expertise and attention, they can seriously compromise the patient's life and even lead to death.
Downloads
References
Rebello RJ, Oing C, Knudsen KE, Loeb S, Johnson DC, Reiter RE, et al. Prostate cancer. Nat Rev Dis Primers [Internet]. 2021 Dec 1 [cited 2023 May 14];7(1). Available from: https://pubmed.ncbi.nlm.nih.gov/33542230/
Thorpe CS, Bhangoo RS, Anderson JD, Jason Shen J, Vargas CE. Prostate Cancer. Principles and Practice of Particle Therapy [Internet]. 2023 Mar 11 [cited 2023 May 14];383–410. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470550/
Emiliozzi P, Corsetti A, Tassi B, Federico G, Martini M, Pansadoro V. Best approach for prostate cancer detection: A prospective study on transperineal versus transrectal six-core prostate biopsy. Urology [Internet]. 2003 May 1 [cited 2023 May 14];61(5):961–6. Available from: https://pubmed.ncbi.nlm.nih.gov/12736016/
Ismail MT, Gomella LG. Transrectal prostate biopsy. Urol Clin North Am [Internet]. 2013 Nov [cited 2023 Jun 26];40(4):457–72. Available from: https://pubmed.ncbi.nlm.nih.gov/24182969/
Xiang J, Yan H, Li J, Wang X, Chen H, Zheng X. Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer: a systematic review and meta-analysis. World J Surg Oncol [Internet]. 2019 Feb 13 [cited 2023 May 14];17(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30760274/
Bhanji Y, Allaway MJ, Gorin MA. Recent Advances and Current Role of Transperineal Prostate Biopsy. Urol Clin North Am [Internet]. 2021 Feb 1 [cited 2023 May 14];48(1):25–33. Available from: https://pubmed.ncbi.nlm.nih.gov/33218591/
Zolper EG, Lu J, Sher SR, Attinger CE, Evans KK. Septic Shock following Prostate Biopsy: Aggressive Limb Salvage for Extremities after Pressor-Induced Ischemic Gangrene. Plast Reconstr Surg [Internet]. 2020 [cited 2023 May 13];146(1):107E-108E. Available from: https://pubmed.ncbi.nlm.nih.gov/32590686/
Taylor GM, Paratore DM. Septic shock secondary to acute bacterial prostatitis in an HIV-positive male: a novel presentation. Oxf Med Case Reports [Internet]. 2018 Nov 1 [cited 2023 May 14];2018(11). Available from: https://pubmed.ncbi.nlm.nih.gov/30364294/
Prostate biopsy - UpToDate [Internet]. [cited 2023 May 14]. Available from: https://www.uptodate.com/contents/prostate-biopsy/print?search=sepsis
Interpretation of prostate biopsy - UpToDate [Internet]. [cited 2023 May 14]. Available from: https://www.uptodate.com/contents/interpretation-of-prostate-biopsy/print?search=cancer
Gram-negative bacillary bacteremia in adults - UpToDate [Internet]. [cited 2023 May 14]. Available from: https://www.uptodate.com/contents/gram-negative-bacillary-bacteremia-in-adults/print?search=sepsis
Basourakos SP, Alshak MN, Lewicki PJ, Cheng E, Tzeng M, DeRosa AP, et al. Role of Prophylactic Antibiotics in Transperineal Prostate Biopsy: A Systematic Review and Meta-analysis. Eur Urol Open Sci. 2022 Mar 1;37:53–63.
Pradere B, Veeratterapillay R, Dimitropoulos K, Yuan Y, Omar MI, MacLennan S, et al. Nonantibiotic Strategies for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol [Internet]. 2021 Mar 1 [cited 2023 May 14];205(3):653–63. Available from: https://www.auajournals.org/doi/10.1097/JU.0000000000001399
Pilatz A, Dimitropoulos K, Veeratterapillay R, Yuan Y, Omar MI, MacLennan S, et al. Antibiotic prophylaxis for the prevention of infectious complications following prostate biopsy: A systematic review and meta-analysis. Journal of Urology. 2020 Aug 1;204(2):224–30.
Samarinas M. Editorial Comments on Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol. 2020 Sep 1;204(3):414.
Pilatz A, Dimitropoulos K, Veeratterapillay R, Yuan Y, Omar MI, MacLennan S, et al. Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol [Internet]. 2020 Aug 1 [cited 2023 May 14];204(2):224–30. Available from: https://www.auajournals.org/doi/10.1097/JU.0000000000000814
Castañeda RR, Buitrago AC, León F, Yaspe E, Romero G. Frecuencia de adenocarcinoma de próstata localizado, en zonas transicional y periférica, en biopsias transrectales ecodirigidas, practicadas en el Hospital de San José en el periodo de mayo de 2008 a abril de 2009. Revista Urología Colombiana [Internet]. 2011 [cited 2023 May 14];XX(1):21–6. Available from: https://www.redalyc.org/articulo.oa?id=149122332003
Castellani D, Pirola GM, Law YXT, Gubbiotti M, Giulioni C, Scarcella S, et al. Infection Rate after Transperineal Prostate Biopsy with and without Prophylactic Antibiotics: Results from a Systematic Review and Meta-Analysis of Comparative Studies. J Urol [Internet]. 2022 Jan 1 [cited 2023 May 14];207(1):25–34. Available from: https://www.auajournals.org/doi/10.1097/JU.0000000000002251
Losco G, Studd R, Blackmore T. Ertapenem prophylaxis reduces sepsis after transrectal biopsy of the prostate. BJU Int [Internet]. 2014 [cited 2023 May 14];113 Suppl 2(SUPPL. 2):69–72. Available from: https://pubmed.ncbi.nlm.nih.gov/24894854/
Jiang P, Liss MA, Szabo RJ. Targeted Antimicrobial Prophylaxis Does Not Always Prevent Sepsis after Transrectal Prostate Biopsy. Journal of Urology. 2018 Aug 1;200(2):361–8.
Singhan W, Vadcharavivad S, Areepium N, Wittayalertpanya S, Chaijamorn W, Srisawat N. The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support. J Crit Care. 2019 Jun 1;51:71–6.
Forsvall A, Jönsson H, Wagenius M, Bratt O, Linder A. Rate and characteristics of infection after transrectal prostate biopsy: a retrospective observational study. Scand J Urol [Internet]. 2021 [cited 2023 May 14];55(4):317–23. Available from: https://pubmed.ncbi.nlm.nih.gov/34096449/
Cutuli SL, Cascarano L, Lazzaro P, Tanzarella ES, Pintaudi G, Grieco DL, et al. Antimicrobial Exposure in Critically Ill Patients with Sepsis-Associated Multi-Organ Dysfunction Requiring Extracorporeal Organ Support: A Narrative Review. Microorganisms. 2023 Feb 1;11(2).
de Jonge NA, Sikkens JJ, Zweegman S, Beeker A, Ypma P, Herbers AH, et al. Short versus extended treatment with a carbapenem in patients with high-risk fever of unknown origin during neutropenia: a non-inferiority, open-label, multicentre, randomised trial. Lancet Haematol [Internet]. 2022 Aug 1 [cited 2023 May 14];9(8):e563–72. Available from: http://www.thelancet.com/article/S2352302622001454/fulltext
Chaijamorn W, Rungkitwattanakul D, Pattharachayakul S, Singhan W, Charoensareerat T, Srisawat N. Meropenem dosing recommendations for critically ill patients receiving continuous renal replacement therapy. J Crit Care. 2020 Dec 1;60:285–9.
Asner SA, Desgranges F, Schrijver IT, Calandra T. Impact of the timeliness of antibiotic therapy on the outcome of patients with sepsis and septic shock. Journal of Infection [Internet]. 2021 May 1 [cited 2023 May 14];82(5):125–34. Available from: http://www.journalofinfection.com/article/S016344532100116X/fulltext
Kubo K, Kondo Y, Yoshimura J, Kikutani K, Shime N. Short- versus prolonged-course antibiotic therapy for sepsis or infectious diseases in critically ill adults: a systematic review and meta-analysis. Infect Dis [Internet]. 2022 [cited 2023 May 14];54(3):213–23. Available from: https://www.tandfonline.com/doi/abs/10.1080/23744235.2021.2001046
Clinical approach to Staphylococcus aureus bacteremia in adults - UpToDate [Internet]. [cited 2023 May 14]. Available from: https://www.uptodate.com/contents/clinical-approach-to-staphylococcus-aureus-bacteremia-in-adults?search=Abordaje%20cl%C3%ADnico%20de%20la%20bacteriemia%20por%20Staphylococcus%20aureus%20en%20adultos&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Danielsen L, Faizi G, Snitgaard S, Lund L, Frey A. Infections after transrectal ultrasonic guided prostate biopsies - a retrospective study. Scand J Urol [Internet]. 2019 May 4 [cited 2023 May 14];53(2–3):97–101. Available from: https://pubmed.ncbi.nlm.nih.gov/31070079/
Mrad Dali K, Rahoui M, Chaker K, Ouanes Y, Bibi M, Sellami A, et al. Positive urine culture prior to transrectal prostate biopsy was not associated with infectious complications development. Progres en Urologie. 2022 Oct 1;32(12):830–5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 LA CIENCIA AL SERVICIO DE LA SALUD Y NUTRICIÓN
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
