difficile by using the VITEK 2 system (bioMerieux, Marcy-I'Etoil, France), with 99% probability. Subsequently, blood culture on HD 163 showed the absence of pathogens in the patient's blood.īlood cultures on HD 186 revealed the presence of anaerobic gram-positive bacilli, which were subcultured on blood agar and incubated anaerobically. On HD 157, the patient's blood culture showed the presence of Enterococcus faecium, and the patient was again treated with meropenem. On HD 146, the patient showed hematochezia through the site of ileostomy. As a result, the antibiotic therapy was changed to piperacillin/metronidazole. On HD 141, the fever recurred and blood culture revealed the presence of Escherichia coli. On HD 113, loop ileostomy was performed, and antibiotic therapy involving ticarcillin was initiated. On hospitalization day (HD) 98, the patient developed fever, and antibiotic therapy with vancomycin/meropenem was initiated. Consequently, the patient underwent nephrostomy in the pelvic region in conjunction with insertion of a stent in the colon. External compression of the rectum due to metastasis was suspected as the cause of rectal stricture.
The cancer recurred after 2 yr and eventually metastasized to multiple sites, causing hydronephrosis, obstructive acute kidney injury, and rectal stricture. A 60-yr-old Korean man had been diagnosed with prostate cancer 4 yr ago and was followed up after chemotherapy.
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