[Pyogenic spondylitis by Enterobacter cloacae as a postoperative complication of TURP: a case report].
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.
Hatano
Koji
K
The Department of Urology, Osaka Police Hospital.
Sato
Mototaka
M
Tsujimoto
Yuichi
Y
Takada
Tsuyoshi
T
Honda
Masato
M
Matsumiya
Kiyomi
K
Mizutani
Tetsu
T
Fujioka
Hideki
H
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
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D017334:Teicoplanin; D000077731:Meropenem