Spondylodiscitis with Epidural and Psoas Muscle Abscesses as Complications After Transrectal Ultrasound-guided Prostate Biopsy: Report of a Rare Case

Abstract

A 71-year-old man presented with spondylodiscitis with epidural and psoas muscle abscesses following transrectal ultrasound (TRUS)-guided prostate biopsy. These rare complications were detected by computed tomography of the abdomen and magnetic resonance imaging of the lumbar spine. The patient was successfully treated with antibiotics and underwent neurosurgery. Awareness of presentations such as backache and weakness of the lower limbs after prostate biopsy is important as these symptoms are usually mistaken for bone or muscle problems and often not recognized as being related to infection. LEARNING POINTS• We describe the case of a patient who experienced two major complications (spondylodiscitis with epidural abscess and psoas muscle abscess) following prostate biopsy.• Awareness of these potential complications following prostate biopsy is essential to prevent life-threatening consequences. KEYWORDS Spondylodiscitis; prostate biopsy; transrectal ultrasound; psoas muscle abscess INTRODUCTION Approximately 1 million transrectal ultrasound (TRUS)-guided prostate biopsies are performed annually in the United States. The procedure is considered safe, but minor complications are common and include haematuria, rectal haemorrhage and haematospermia. Major complications, such as infections, are occasionally observed. Here, we report the case of a patient who experienced two major complications (spondylodiscitis with epidural abscess and psoas muscle abscess) following prostate biopsy. He presented with fever, backache and lower limb weakness. We describe this case in order to highlight these complications as most physicians are not aware these problems can occur after prostate biopsy.

Pyogenic Spondylodiscitis Following Nonspinal Cesarean Section

“…Only a few cases of spondylitis were reported after genitourinary procedures, including prostate biopsy [ 7 ], rectopexy [ 8 ], sacrohysteropexy [ 9 ], and vaginal delivery [ 10 ]. The pathophysiology of pyogenic spondylodiscitis may be attributed to transient bacteremia after these interventions [ 11 , 12 ].…”

Spondylodiscitis, an Exceptional Complication of Prostate Biopsy: Case Report

“…Resistance to fluoroquinolone has been reported as one of the factors associated to increasing infection occurring after prostate biopsy [3]. Although some cases have been reported in the literature, the osteo-articular localization is exceptional but can have life-threatening consequences [4]. We report the case of an immunocompetent patient presented with spondylodiscitis following transrectal prostate biopsy.…”

Prosztatabiopszia után kialakult kétoldali psoas tályog esete

“…Li és munkatársai ismertettek ugyan egy esetet, ahol egy 71 éves férfinél spondylodiscitis alakult ki kétoldali psoas és epiduralis tályoggal transrectalis ultrahangvezérelt prosztatabiopsziát követően, de itt a tályogok mérete nem volt számottevő, és nem terjedtek a paralumbalis izomzatba, így konzervatív kezelés elegendő volt. A spondylodiscitis megoldása viszont idegsebészeti úton történt (7). Lundy és munkatársai egy prosztatabiopszia után kialakult epiduralis tályog esetének feldolgozása során vizsgálták az ebben a témában megjelent cikkeket, és kevesebb, mint 20 esetet találtak, köztük a már említett Li és munkatársai által leírtat, vagy a Majoros és munkatársai által 2004-ben közölt esetet (8).…”