I'm no doctor, but it sounds like a prostate infection. Biopsies inject fecal matter into the prostate. The bacteria there are becoming increasingly resistant to the fluoroguinolone antibiotics (e.g., Cipro, Levaquin, Avelox, etc.)
AUA/SUNA White Paper on the Incidence, Prevention and Treatment of Complications Related to Prostate Needle Biopsy
Here's what the AUA said...
Treatment of Infection:
Post-prostate biopsy infections may be serious and, if unrecognized, can lead to significant morbidity or even death. Patients must be counseled to contact their physician immediately if they have fever, lethargy, difficulty voiding, testicular swelling or symptoms suggestive of a urinary tract infection. Infectious complications after prostate biopsy include cystitis, epididymoorchitis, prostatitis, and urosepsis. If a patient demonstrates signs or symptoms of sepsis, immediate intravenous hydration and broad-spectrum antimicrobials should be initiated.
Once culture sensitivities have been ascertained, antimicrobials may be adjusted appropriately.Initial therapy must cover E. coli (the most common pathogen) as well as numerous other organisms. Prior to treatment, a urine culture (and blood cultures if the patient is febrile) should be obtained. Because of widespread ampicillin- and fluoroquinolone-resistance, alternative empiric antimicrobials should be selected.
Older studies evaluating resistance patterns in patients with post-prostate biopsy sepsis noted high rates of resistance to many of the commonly used antimicrobials and recommended the use of a second or third generation cephalosporin, amikacin, or carbapenem.More recent studies have noted significant resistance to fluoroquinolones (90%), piperacillin (72%), trimethoprim/sulfamethoxazole (44%) and even gentamicin (22). However, most of the current literature notes no or minimal resistance to the carbapenems (imipenem and meropenem) and amikacin.
In addition, the second- and third-generation cephalosporins maintain reasonably good sensitivities as well. Clinicians may choose from these options but should be familiar with their local antibiogram.
•3rd biopsy (4/2010):
PSA=7.3, prostate volume=55cc, 8 of 17 cores G6 5-35% involvement
•SBRT (5x8Gy) at UCLA, 10/2010 at age 57
•PSA since treatment:
+3 mos:3.9 +4 mos:3.5 +7 mos:3.0 +10 mos:3.7 +13 mos:3.6 +19 mos:1.18 +23 mos:1.29 +29 mos:.37
• Side Effects of treatment:
+2 wks: Grade 1 urinary & rectal last 1 wk
+1 yr: Grade 1 urinary last 2 months
Post Edited (Tall Allen) : 4/7/2013 2:10:37 PM (GMT-6)