title: [Fatal septic shock caused by transrectal needle biopsy of the prostate; a case report].
abstract: A 46-year-old man refer to us because of hemospermia. The prostatic gland was normal in size and consistency at rectal examination. Serum prostate specific antigen was 7.04 ng/ml. Magnetic resonance imaging showed an area of low signal intensity on T2-weighted images in the left peripheral gland, possibly indicative of carcinoma. Transrectal prostate biopsy was performed after intravenous administration of piperacillin. He developed chills and fever (39 degrees C) the next morning following biopsy. He was taken unconscious into the hospital where a diagnosis of septic shock caused by Escherichia coli was made. Five days later, he died. His general condition deteriorated notwithstanding intensive treatment. Postmortem blood cultures were positive for a piperacillin resistant Escherichia coli. Histological examination of the biopsies showed a benign prostatic hyperplasia. Autopsy showed diffuse tissue damage in the heart, lung, liver and kidneys. The prostate had numerous microabscesses. Currently, transrectal prostate biopsy is considered a generally reliable procedure to detect adenocarcinoma of the prostate. Our case seems to the sixth case report of fatal complications.
authors.affiliation: Department of Urology, Jikei University, School of Medicine.
authors.forename: Taro
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Tatuya
authors.initials: T
authors.lastname: Shimomura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Nobuki
authors.initials: N
authors.lastname: Kato
authors.forename: Norio
authors.initials: N
authors.lastname: Hasegawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Asano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kiyota
authors.forename: Isao
authors.initials: I
authors.lastname: Ikemoto
authors.forename: Shouichi
authors.initials: S
authors.lastname: Onodera
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Oishi
mesh_terms: D016470:Bacteremia / Q000150:complications*; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D004926:Escherichia coli / Q000302:isolation & purification; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012772:Shock, Septic / Q000209:etiology*