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 transrectal ultrasonography-guided prostate biopsy has been reported to range from 0.1% to 7%, with Escherichia coli being the most common organism identified. The conventional wisdom is to recommend an interval of more than 4 to 6 weeks after the transrectal prostate biopsy before treating patients with radical prostatectomy. This allows time for resolution of the biopsy-induced inflammation, which might complicate the surgical planes for dissection. We present 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 prostatectomy 31 days after the prostate biopsy.