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Peer-reviewedCC BYCureus

Bacterial Meningitis Following Robot-Assisted Radical Prostatectomy After Neoadjuvant Precision Oncology-Directed Therapy: A Case Report.

  • Thomas Allen1
  • Gabrielle R Yankelevich1,2
  • Stephen J Savage1,3
  • Paul Womble1,3
  1. 1Department of Urology, Medical University of South Carolina, Charleston, USA.
  2. 2Department of Urology, Moffitt Cancer Center, Tampa, USA.
  3. 3Department of Surgery, Ralph H. Johnson Veterans Affairs Health Care System, Charleston, USA.
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Abstract

To our knowledge, bacterial meningitis following radical prostatectomy has not been previously reported. We present a 69-year-old male who had phosphatase and tensin homolog (PTEN)-deficient high-risk locoregional prostate cancer and received neoadjuvant leuprolide, abiraterone, prednisone, and capivasertib in the Single-Arm Phase II Study of Neoadjuvant Intensified Androgen Deprivation in Combination with protein kinase B (AKT) Inhibition (SNARE) trial and developed bacterial meningitis following robot-assisted radical prostatectomy. Diagnosis was established by cerebrospinal fluid analysis demonstrating leukocytosis and markedly elevated protein, although cultures were negative following prior antibiotic exposure. Though capivasertib is not considered overtly immunosuppressive, it is possible that a combination of androgen deprivation, low-dose steroids, alcohol use disorder, and surgical intervention resulted in a permissive immunologic environment for infection. This represents, to our knowledge, the first documented case of bacterial meningitis arising after radical prostatectomy. The relationship to his neoadjuvant therapy remains unclear.

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Cite

BibTeXRIS
BibTeX
@article{allen2026bacterial,
  title = {{Bacterial Meningitis Following Robot-Assisted Radical Prostatectomy After Neoadjuvant Precision Oncology-Directed Therapy: A Case Report.}},
  author = {Thomas Allen and Gabrielle R Yankelevich and Stephen J Savage and Paul Womble},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116726},
  url = {https://europepmc.org/article/MED/42924219},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Bacterial Meningitis Following Robot-Assisted Radical Prostatectomy After Neoadjuvant Precision Oncology-Directed Therapy: A Case Report.
AU  - Thomas Allen
AU  - Gabrielle R Yankelevich
AU  - Stephen J Savage
AU  - Paul Womble
PY  - 2026
DA  - 2026/09/22
JO  - Cureus
DO  - 10.7759/cureus.116726
UR  - https://europepmc.org/article/MED/42924219
AB  - To our knowledge, bacterial meningitis following radical prostatectomy has not been previously reported. We present a 69-year-old male who had phosphatase and tensin homolog (PTEN)-deficient high-risk locoregional prostate cancer and received neoadjuvant leuprolide, abiraterone, prednisone, and capivasertib in the Single-Arm Phase II Study of Neoadjuvant Intensified Androgen Deprivation in Combination with protein kinase B (AKT) Inhibition (SNARE) trial and developed bacterial meningitis following robot-assisted radical prostatectomy. Diagnosis was established by cerebrospinal fluid analysis demonstrating leukocytosis and markedly elevated protein, although cultures were negative following prior antibiotic exposure. Though capivasertib is not considered overtly immunosuppressive, it is possible that a combination of androgen deprivation, low-dose steroids, alcohol use disorder, and surgical intervention resulted in a permissive immunologic environment for infection. This represents, to our knowledge, the first documented case of bacterial meningitis arising after radical prostatectomy. The relationship to his neoadjuvant therapy remains unclear.
SN  - 2168-8184
ER  -