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What Causes Klebsiella Infection After Laser Ablation Therapy For Prostate?
Question: After having laser ablation therapy to remove a 1 cm XXXXXXX 6 lesion on my prostate, I was catheterized for 4 weeks. On removal of catheter i had a highly resistant form of Klebsiella infection. The infectious disease doctor waited 2 weeks before putting me on I.V. Ertapenem for two weeks. Symptoms cleared and urine was clear. After 3 weeks, urine turned cloudy and urinalysis showed klebsiella again -- same resistant strain. Back on Ertapenem and in first week also showed symptoms of epidydimitis. I have just come off 8 weeks of I.V. Ertapenem, but still have mild symptoms - some testicular sensitivity as we as urethral sensitivity. Worried that (a) I may not be rid of this and (b) how does one deal with this long term. Is this infection sexually transmittable, either orally or vaginally? Are there alternative ways to get rid of it?
Brief Answer:
No choice but to take appropriate antibiotic as per culture report .
Detailed Answer:
Hello
Thanks for query .Based on the facts that you have developed UTI due to organisms sensitive to only Carbapenem group of antibiotics Klebsiella and have been treated with Ertapenem for 3 weeks but unfortunately developed infection of epididymitis.
In treating any infection there is no option but to take appropriate antibiotic as per culture report or if technically feasible remove the source of infection .
Repeat urine culture again with the hope that there may be change in bacterial flora and sensitivity pattern .
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.
No choice but to take appropriate antibiotic as per culture report .
Detailed Answer:
Hello
Thanks for query .Based on the facts that you have developed UTI due to organisms sensitive to only Carbapenem group of antibiotics Klebsiella and have been treated with Ertapenem for 3 weeks but unfortunately developed infection of epididymitis.
In treating any infection there is no option but to take appropriate antibiotic as per culture report or if technically feasible remove the source of infection .
Repeat urine culture again with the hope that there may be change in bacterial flora and sensitivity pattern .
Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you, but I think you missed the gist of my question:
1. I have completed 8 (not 3) weeks of ertapenem and that is the full course of treatment. My urine culture is clear. Despite this, I still have some residual sensitivity/pain in the one testicle as well as the urethra. Does this sensitivity suggest that the infection is still in my body?
2. If so, can this bacterial infection be passed with sexual intercourse, either orally or vaginally?
3. Is there a long term strategy you can recommend to avoid another flare up of this infection?
1. I have completed 8 (not 3) weeks of ertapenem and that is the full course of treatment. My urine culture is clear. Despite this, I still have some residual sensitivity/pain in the one testicle as well as the urethra. Does this sensitivity suggest that the infection is still in my body?
2. If so, can this bacterial infection be passed with sexual intercourse, either orally or vaginally?
3. Is there a long term strategy you can recommend to avoid another flare up of this infection?
Brief Answer:
The symptoms could be due to mild residual inflammation
Detailed Answer:
Hello
Thanks for follow up .
It is possible to get mild symptoms in case of chronic infection and the possibility of residual inflammation can be ruled out only after repeating urine culture .
There is possibility of transmitting infection through sexual intercourse but not through oral sex .
Have a safe protected sex till you it gets resolved completely and take prophylactic antibiotic like Nitrofurantoin twice daily for 4-6 weeks .
Thanks and Regards.
Dr.Patil.
The symptoms could be due to mild residual inflammation
Detailed Answer:
Hello
Thanks for follow up .
It is possible to get mild symptoms in case of chronic infection and the possibility of residual inflammation can be ruled out only after repeating urine culture .
There is possibility of transmitting infection through sexual intercourse but not through oral sex .
Have a safe protected sex till you it gets resolved completely and take prophylactic antibiotic like Nitrofurantoin twice daily for 4-6 weeks .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you! Interesting suggestion about prophylactic at this point? But will something like Nitrofurantoin work as a prophylactic in this case where Klebsiella showed sensitivity only to Carbapenems?
Would your guess be that my immune system is low? I know you can only guess.
Something i didn't mention is that I am one of those men that took Finasteride (Proscar) for a month in an attempt to deal with BPH and high PSA, and I was left with post finasteride syndrome symptoms.
I did work with an Endocrinologist to try to overcome those symptoms and did testosterone injections. Though they didn't solve all the symptoms, they succeeded in making me feel much better. I stopped because of the PSA going up again. Would it be safe to resume? Since the Finasteride, I have multiple small problems that don't seem to heal normally. Before taking it in 2010, I was a pretty healthy 64 year old.
Would your guess be that my immune system is low? I know you can only guess.
Something i didn't mention is that I am one of those men that took Finasteride (Proscar) for a month in an attempt to deal with BPH and high PSA, and I was left with post finasteride syndrome symptoms.
I did work with an Endocrinologist to try to overcome those symptoms and did testosterone injections. Though they didn't solve all the symptoms, they succeeded in making me feel much better. I stopped because of the PSA going up again. Would it be safe to resume? Since the Finasteride, I have multiple small problems that don't seem to heal normally. Before taking it in 2010, I was a pretty healthy 64 year old.
Brief Answer:
Since you have cancer of the prostate it is better not to take Testosterone
Detailed Answer:
Hello
Thanks for follow up .
The side effects of Finasteride will not long for such a long period and considering your prostate lesion it is safe not to take Testosterone injections as raised PSA will make it very difficult to judge the progress of the disease .
Nitrofurantoin is urinary antiseptic and advised routinely in case of residual inflammation .
Thanks and Regards.
Dr XXXXXXX
Since you have cancer of the prostate it is better not to take Testosterone
Detailed Answer:
Hello
Thanks for follow up .
The side effects of Finasteride will not long for such a long period and considering your prostate lesion it is safe not to take Testosterone injections as raised PSA will make it very difficult to judge the progress of the disease .
Nitrofurantoin is urinary antiseptic and advised routinely in case of residual inflammation .
Thanks and Regards.
Dr XXXXXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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