meropenem and Adenocarcinoma

Topics: Abscess; Adenocarcinoma; Anti-Bacterial Agents; Chemoradiotherapy; Combined Modality Therapy; Drainage; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Esophagoscopy; Humans; Lung Neoplasms; Male; Meropenem; Middle Aged; Neck; Smoking; Streptococcal Infections; Streptococcus anginosus; Subcutaneous Tissue; Superior Vena Cava Syndrome; Thoracic Diseases; Tomography, X-Ray Computed

A 44-year-old Indian national with a prostate-specific antigen of 5.4 ng/mL underwent 12-core transrectal ultrasound-guided prostate biopsies. Following this, he had three hospital admissions with severe urosepsis secondary to extended spectrum β lactamase (ESBL) producing Escherichia coli. He had recurrent sepsis immediately after discontinuation of intravenous meropenem to which the ESBL was sensitive. He proceeded to radical prostatectomy for intermediate-high risk Gleason 7 prostate cancer, while still on intravenous meropenem, 2 months after his biopsy. His prostatectomy involved a difficult dissection due to inflammatory changes and fibrosis after multiple septic episodes. He had complete resolution of infection after surgery with discontinuation of antibiotics on the third postoperative day, without any recurrence of sepsis.

Topics: Adenocarcinoma; Adult; Anti-Bacterial Agents; Drug Resistance, Bacterial; Escherichia coli Infections; Humans; Image-Guided Biopsy; Male; Meropenem; Neoplasm Grading; Prostatectomy; Prostatic Neoplasms; Prostatitis; Recurrence; Thienamycins