Is prostatic biopsy as safe as we think? Epidural abscess following prostatic biopsy.
Spinal epidural abscess is an infectious disorder with high morbidity and mortality rates, which is often associated with delayed diagnosis. We report a case of a 73-year-old man with cervical pyogenic spondylodiscitis complicated with epidural abscess following a prostatic biopsy. Clinical presentation included fever, malaise, neck rigidity in all axes, minor paresis of the right arm, and gait ataxia. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylodiscitis with an epidural abscess. Blood, urine, and cerebrospinal fluid cultures were sterile. The patient was treated with intravenous vancomycin, metronidazole, and ceftazidime for 4 weeks, and was discharged from the hospital and treated with oral cloxacillin, metronidazole, and cefixime for another 2 weeks. His neurological symptoms disappeared completely, and he walked normally, without support. It is important for clinicians to be alert to symptoms accompanying back pain following a prostatic biopsy and to consider the possibility of a diagnosis of spinal abscess.
Aguilar-Shea
A L
AL
Servicio de Medicina Interna, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain.
Molino-González
A M
AM
Gallardo-Mayo
C
C
Pedradas-Navas
J M
JM
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000009:adverse effects*; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D020802:Epidural Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011469:Prostatic Diseases / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents