title: [Pyogenic spondylitis by Enterobacter cloacae as a postoperative complication of TURP: a case report].
abstract: We report a case of pyogenic spondylitis caused by Enterobacter cloacae as a rare complication of transurethral resection of the prostate (TURP). A 79-year-old man underwent TURP. Immediate after removal of urethral catheter on postoperative day (POD) 7, he developed high fever > 40 degrees C with increased acute inflammatory reaction. Urine and blood culture detected E. cloacae and methicillin-resistant Staplylococcus aureus. He complained of lumbago since POD 9. Two-week administration of imipenem and teicoplanin resulted in resolution of fever as well as laboratory data, so intravenous antibiotics were changed to oral gatifloxacin. However, his lumbago worsened and gait disturbance appeared. On POD 39, diagnosis of pyogenic spondylitis was finally obtained by Ga-scintigraphy and magnetic resonance imaging. Aspiration of the intervertebral disk (L4-5) revealed E. cloacae as the causative organism of pyogenic spondylitis. His condition improved after conservative treatment with teicoplanin, meropenem and ciplofloxacin for 9 weeks.
authors.affiliation: The Department of Urology, Osaka Police Hospital.
authors.forename: Koji
authors.initials: K
authors.lastname: Hatano
authors.forename: Mototaka
authors.initials: M
authors.lastname: Sato
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tsujimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takada
authors.forename: Masato
authors.initials: M
authors.lastname: Honda
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Matsumiya
authors.forename: Tetsu
authors.initials: T
authors.lastname: Mizutani
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujioka
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D016972:Enterobacter cloacae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D000077731:Meropenem; D011183:Postoperative Complications; D013166:Spondylitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013492:Suppuration; D017334:Teicoplanin / Q000627:therapeutic use; D013845:Thienamycins / Q000627:therapeutic use; D020728:Transurethral Resection of Prostate
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D017334:Teicoplanin; D000077731:Meropenem