エンドトキシン吸着療法により救命しえたESBL産生大腸菌による経直腸前立腺針生検後敗血症の1例

Abstract

A 62-year-old man, with a family history of prostate cancer, referred to our hospital because of elevated prostate-specific antigen (PSA) (6.02 ng/ml). After prophylactic administration of antibiotics (cefotiam), transrectal needle biopsy of the prostate was performed. He was admitted to the hospital due to high fever the next evening. His blood pressure was below the shock level, and his renal function deteriorated progressively. Suspecting septic shock, the patient was treated with Meropenem, γ-globulin, and dopamine, which were not effective. Then, endotoxin adsorption therapy was employed and the condition of the patient recovered soon after the initiation of the therapy. Extended spectrum β -lactamase-producing Escherichia coli was found in his urine. Pathological diagnosis of the biopsy specimen was atypical glands.