Robot-assisted laparoscopic radical prostatectomy after fluoroquinolone resistant Escherichia coli sepsis following a transrectal ultrasonography-guided prostate biopsy

The incidence of febrile urinary tract infection after transrectalultrasonography-guided prostate biopsy has been reported to rangefrom 0.1% to 7%, with Escherichia coli being the most commonorganism identified. The conventional wisdom is to recommendan interval of more than 4 to 6 weeks after the transrectal prostatebiopsy before treating patients with radical prostatectomy. Thisallows time for resolution of the biopsy-induced inflammation,which might complicate the surgical planes for dissection. Wepresent a 58-year-old man with an elevated prostate-specific antigen,who developed near-fatal sepsis following transrectal ultrasonography-guided prostate biopsy despite quinolone prophylaxis.The patient underwent a robot-assisted laparoscopic radical prostatectomy31 days after the prostate biopsy.