E. coli bacterial meningitis after transrectal prostate biopsy under antibiotic prophylaxis: a case report and literature review

• Published in: Clinical case reports Vol. 10; no. 5; pp. e05921 - n/a
• Main Authors: Vandewalle, Tom, Vander Eeckt, Kathy, Deconinck, Steven, Weyne, Emmanuel, Verpoort, Pieter, Ost, Dieter
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-05-2022; John Wiley and Sons Inc; Wiley
• Subjects: Antibiotics; Bacteria; Bacterial infections; Biopsy; Case Report; Case Reports; Disease prevention; Drug resistance; E coli; Gram-positive bacteria; Headaches; Hematuria; Magnetic resonance imaging; Meningitis; Mortality; Neutrophils; prostate biopsy; Prostate cancer; Streptococcus infections; Ultrasonic imaging; Urinary tract diseases; Urinary tract infections; Urine; Urogenital system; prostate biopsy; E. coli; meningitis
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.5921

Prostate biopsy, a frequently performed procedure, is not harmless. In rare cases, life‐threatening complications occur. We document a potential lethal bacterial meningitis after transrectal biopsy. In addition to our overview of all previously documented cases, we highlight the evidence of prevention of infectious complications when performing a prostate biopsy.
Even after antibiotic prophylaxis, severe infections sometimes follow transrectal prostate biopsy. Involvement of the central nervous system is not well known but demands early recognition. In this situation, intravenous antibiotics with a high penetration through the blood–brain barrier are of vital importance. The most effective preventive measure against infectious complications is to change the biopsy approach to transperineal.