title: [A case report of Fournier's gangrene in a diabetic patient induced by transrectal prostate biopsy (TRPB)].
abstract: A 70-year-old man with poorly controlled diabetes mellitus, and an elevated serum prostatic specific antigen, underwent transrectal prostate biopsy. He received one dose of cefotium before, and three doses of cefotium (1.0 gram every 12 hours intravenously) after prostatic biopsy. He was doing well until postbiopsy day 1, when he developed high fever, dysuria and lower abdominal pain. His perineal area exhibited black-purpish discoloration. On postbiopsy day 3, laboratory data showed leukopenia and DIC. Operative findings during laparotomy on the same day, included malodorous cloudy fluid and tissue edema involving the perivesical space. Intraoperative tissue cultures as well as postoperative cultures of blood and drainage revealed Escherichia coli, serotype O-6. Despite maximal supportive therapy, the patient developed multiorgan failure and died on the tenth postbiopsy day. This patient's history and hospitalization course suggests that transrectal prostatic biopsy induced Fournier's gangrene.
authors.affiliation: Department of Urology, Teine Keijinkai Hospital.
authors.forename: Akira
authors.initials: A
authors.lastname: Kumagai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ogawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Koyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Itaru
authors.initials: I
authors.lastname: Oyama
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D048909:Diabetes Complications; D017809:Fatal Outcome; D018934:Fournier Gangrene / Q000209:etiology*; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D012007:Rectum