Post-prostate Biopsy Septic Shock Due to Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli: A Case Report

Prostate biopsy is a commonly performed urological procedure, yet infectious complications, including sepsis and bacteremia, remain a significant and potentially life-threatening risk. We present a case of a 65-year-old male patient who developed urosepsis with Escherichia coli extended-spectrum beta-lactamase (ESBL)-producing bacteremia following a transrectal prostate biopsy. Despite an initially non-toxic appearance, the patient rapidly deteriorated, requiring vasopressor support and intensive care unit admission. Empiric therapy with vancomycin and ceftriaxone was initiated, and antibiotic coverage was escalated to meropenem upon identification of an ESBL-producing organism. He subsequently recovered and was discharged in stable condition. This case highlights the importance of early recognition of sepsis in post-procedural patients, the rising threat of ESBL-producing organisms in urological infections, and the need for vigilance even when initial presentations appear benign.