A CASE OF SEPTIC SHOCK AND DISSEMINATED INTRAVASCULAR COAGULATION FOLLOWING TRANSRECTAL PROSTATIC BIOPSY

A 60-year-old man underwent transrectal six sextant ultrasound-guided prostatic biopsy because of gradual elevation of PSA. Despite postoperative use of amikacin, spiking fever developed the next day and after emergency admission (39 hours after the biopsy), his blood pressure decreased to 56/40mmHg with WBC 800/mm3, platelets 6.9×104/mm3 (decreased further to 0.4×104/mm3 on the following day) and FDP 51μg/dl. Intensive care including chemotherapy with broad-spectrum antibiotics and endotoxin removal therapy using a polymyxin B immobilized fiber column (PMX), was useful to recover the patient from septic shock and disseminated intravascular coagulation. As the number of systematic prostatic biopsy is increasing rapidly in Japan, more attention must be paid to potential hazards of this procedure.