609 HOSPITALIZATION FOR FEVER AFTER TRANSRECTAL ULTRASOUND-GUIDED PROSTATE NEEDLE BIOPSY

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2010609 HOSPITALIZATION FOR FEVER AFTER TRANSRECTAL ULTRASOUND-GUIDED PROSTATE NEEDLE BIOPSY Jessica T. Casey, Ronald J. Kim, Hannah H. Alphs, Stacy Loeb, Kent T. Perry, Robert B. Nadler, and William J. Catalona Jessica T. CaseyJessica T. Casey Chicago, IL More articles by this author , Ronald J. KimRonald J. Kim Chicago, IL More articles by this author , Hannah H. AlphsHannah H. Alphs Chicago, IL More articles by this author , Stacy LoebStacy Loeb Baltimore, MD More articles by this author , Kent T. PerryKent T. Perry Chicago, IL More articles by this author , Robert B. NadlerRobert B. Nadler Chicago, IL More articles by this author , and William J. CatalonaWilliam J. Catalona Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Fever, prostatitis, and sepsis are uncommon complications of transrectal ultrasound-guided prostate needle biopsy (PNB). We examined the incidence of fever requiring hospitalization in our institutional PNB series. METHODS From 2006 to 2009, 769 men underwent 945 PNBs by 3 surgeons. Ciprofloxacin was used for prophylaxis. We retrospectively reviewed all cases to determine the incidence of hospitalization following PNB, including data on microbial resistance patterns and clinical course. RESULTS 15 patients (1.6% of PNBs) were hospitalized for fever following PNB. 5 had a history of benign prostatic hyperplasia and one had diabetes mellitus. One-third (5/15) had recently received antibiotic therapy: 2 for respiratory infection, 1 for suspected UTI, and 2 to lower PSA levels. 4 patients had undergone prior PNB. All presented with fever within 1-8 days of PNB and were empirically given broad spectrum parenteral antibiotic therapy. In 12 patients with admission cultures at our institution, 10 (83.3%) grew E. coli. Most (81.8%) were resistant to ciprofloxacin, and one culture (0.9%) grew extended-spectrum beta-lactamase-producing (ESBL) E. coli. This patient developed acute respiratory distress syndrome, requiring endotracheal intubation for >30 days. CONCLUSIONS Febrile episodes requiring hospitalization occurred in 1.6% of PNBs in our series, and in 82% bacteria were resistant to ciprofloxacin. Risk factors might include recent administration of antibiotics. As the potential for life-threatening morbidity exists, we recommend delaying biopsy for 4-6 weeks to give the intestinal flora time to normalize and/or the empiric use of parenteral broad-spectrum antibiotics in patients with a prior history of antibiotic therapy. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e240 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica T. Casey Chicago, IL More articles by this author Ronald J. Kim Chicago, IL More articles by this author Hannah H. Alphs Chicago, IL More articles by this author Stacy Loeb Baltimore, MD More articles by this author Kent T. Perry Chicago, IL More articles by this author Robert B. Nadler Chicago, IL More articles by this author William J. Catalona Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...