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Infection after prostate biopsy

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Posted 8/17/2017 6:18 PM (GMT 0)
My husband had a prostate biopsy July 5 2017. 2 days after the biopsy he was in the emergency with 102.6 fever and severe uncontrollable tremors. Sever UTI was diagnosed and 10 days of Bactrim was prescribed . 1 week after stopping the antibiotic fever and other urinary issues came back with a vengeance...this time they prescribed another round of Bactrim for 14 days. Thought this would clear it but once again 1 week after stopping Bactrim fever was back. Now another round of Bactrim for 30 days. Has anybody else had an infection after the biopsy . We were told this is rare. I am looking to see how long this takes to clear up and what else can be done. Unfortunately more biopsies are in this future since the biopsy showed 2 cores out of 12 with Gleason 6 ....Active Surveillance is the route he is taking for now unless a second opinion on his biopsy slides comes back higher.
Posted 8/17/2017 6:50 PM (GMT 0)
Hello Apotter ....welcome !....wow...so sorry to hear about your husbands infection ....I`ve been here for about a year now and it is very rare that someone posts about and infection after biopsy.....once or maybe twice. Sure hope it resolves itself . sounds like he had the transrectal biopsy like I had . May have to go to the other type ....transperinal (sp?).....anyway , I`m sure some of the others more in the know than I will be along soon to discuss this with you .......Good Luck ....David........I`m a potter too.....(clay)lol
Posted 8/17/2017 7:48 PM (GMT 0)
I have googled everything and there is not much about infection after biopsy except saying only 1 to 5% get an infection which are pretty good odds for not getting one. My husband is also the healthiest person I know...I can't remember him ever having a fever or being sick so,this really was surprising. Fortunately, we live near the Mayo Clinic so since his diagnosis we are going there rather than to the urologist that performed the biopsy. Although Mayo told us it was nothing the urologist did that caused the infection. Hoping somebody posts about their experience with an infection although I don't wish this on anybody, ...no relation to Harry...LOL
Posted 8/17/2017 8:14 PM (GMT 0)
The infection rate for prostate biopsies is around 7% and rising due to resistant infections. Some steps they can take in the future:

• Do a culture of bacteria in the rectum to identify resistant e. coli
• Enema and then swab the rectum with povidone iodine before the biopsy
• Do the biopsy trans-perineal instead of trans-rectal
• Don't repeat the same antibiotics and use them for longer before and afterwards (with probiotics)
Posted 8/17/2017 8:53 PM (GMT 0)
Post biopsy infection may be uncommon but it can be pretty severe. Statistics don't mean squat when you 'win' against the odds.

I had a post biopsy infection that put me in the hospital, as sick as I had ever been. I had the biopsy on a Friday morning, took the post biopsy oral antibiotic, was told I could resume normal activity, and received the usual 'call us if you have any questions' post procedure instructions. By mid-morning Sunday I had a high fever, major body aches, and knew something was really wrong. The urologist wanted to see me first thing Monday and admitted me to the hospital. I spent 3 days on an IV alternating between 2 strong antibiotics around the clock. This was followed by 2 weeks of strong oral antibiotics at home.

The urologist said it was like 1 in 300 odds to have a problem, and I was the first case of infection he had personally had in hundreds of biopsies.
Posted 8/17/2017 9:42 PM (GMT 0)
My husband's biopsy was almost one year ago, Aug 9, 2016. 24 hours after the biopsy he started having fever, chills and nausea. He let me talk him into going to emergency, where he was admitted with a "life threatening infection." We thought we'd get some stronger antibiotics and go home but instead he was in hospital for five days. It took at least three days to find an antibiotic that would work; they kept trying different ones with no improvement.

He's a robustly healthy man, 67 years old at the time, and I've never seen him so sick. They finally diagnosed it as e-coli. He had another three days of outpatient IV treatment and then two weeks of oral antibiotics. Those wreaked some havoc on his gut; I only wish someone had thought to mention probiotics earlier in the game.

The doctors all said the risk of infection was extremely low and that he was just unlucky.

When the urologist came on the last morning to sign the discharge papers, he shared the biopsy results -- positive with a Gleason 8. That was the start of a long year, with surgery in December.

I am pleased to say though that his recovery has been terrific and with no additional treatment needed "at this time."
Posted 8/17/2017 11:38 PM (GMT 0)
As a former microbiologist, I would suggest that you ask whether another antibiotic would be appropriate.
Posted 8/18/2017 2:21 AM (GMT 0)

Unfortunately, infections after a biopsy are anything but rare. Many times they are brought on by the antibiotic used during the biopsy, like sledgehammer, Cipro. Other times, it's the lack of a sterile environment in the doctors office. Lots of potential germs everywhere. Tall Allen's advise is spot on.


Have a stool analysis for C. Diff. That was my biopsy gift. It can kill you, and urologists are irresponsibly clueless about it, in my experience. What is needed is a good gastroenterologist for an evaluation.


We talk a lot about experienced radiologists and surgeons. How about experienced, and knowledgeable biopsy urologists!

Posted 8/18/2017 4:54 AM (GMT 0)
I won the jackpot with infections. Had one after the biopsy, which did clear up pretty well with one round of antibiotics. However then got another a couple of months later after the surgery. That proved very difficult.

The bug was identified as Clostridium Difficile (C-Diff), which as the name implies is very difficult to clear up. It arises when the good bacteria in your gut are compromised by a previous dose of antibiotics letting the C-Diff take over. Took several different antibiotics over a prolonged period of time to clear up.

As garyi suggests, an analysis for C-Diff might be well worthwhile.

The long term gift of C-Diff means you need to be lifelong wary about any further antibiotic treatment.

Hope you get cleared up soon Apotter!

All the best, Chas
Posted 8/18/2017 11:29 PM (GMT 0)
Thank you for all who answered...We were beginning to think he was the only person who had this happen after a biopsy. They are still insisting the Bactrim he is on is the right antibiotic as it was cultured and it was ecoli. I think we need to now explore c-dif. It just seems so strange that the infection keeps coming back after going off it for a week. He is taking probiotics. 2 months of being an an antibiotic can't be a good thing....UGH
Posted 8/19/2017 3:57 AM (GMT 0)
Two of my five biopsies were nightmares, with infection and pain lasting up to six months. Oh yes, they can also cause your PSA to triple. They tend to heal only with time. Antibiotics were useless, Sitz baths did help.

about 2 out of 100 biopsies result in hospitalization for sepsis, and the death rate is 1 out of 1400.

I don't intend to EVER have a prostate biopsy again. That may bump against the protocols of my AS program, but the doctors would have to make a VERY convincing case before I would submit to it.
Posted 8/19/2017 1:33 PM (GMT 0)
My C. Diff was finally knocked out by 14 days on Vancomycin. Yes, another antibiotic. They ALL suck, sometimes worse that the symptoms your taking them for.

BUT, don't ignore C. Diff.....it can kill you!
Posted 8/19/2017 4:37 PM (GMT 0)
He was told he is now high risk for future infections since he was one of the unlucky who got one after his first biopsy. They want to do another one in 12 months.
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