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Chronic mucoid Pseudomonas aeruginosa cholangitis complicating ERCP in a CF patient

Kristin Wallick1, Matthew Dickinson, David S James

  • 1University of Colorado Health Sciences Center, Denver, CO, USA. kristin.wallick@uchsc.edu

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|October 7, 2004
PubMed

Insights

Pseudomonas aeruginosa cholangitis occurred in an adult with cystic fibrosis (CF). The biliary infection, likely introduced during diagnostic procedures, persisted despite treatment.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Cystic Fibrosis Research

Background:

  • Cystic Fibrosis (CF) patients are susceptible to chronic infections.
  • Biliary tract infections are a less common complication in CF patients.

Observation:

  • A case of Pseudomonas aeruginosa cholangitis in an adult CF patient with prior cholecystectomy and intrahepatic biliary stricture is presented.
  • The patient experienced post-procedure complications including pain and fever following ERCP and biliary drainage.

Findings:

  • Pseudomonas aeruginosa was the sole organism identified in biliary drainage.
  • Southern blot analysis confirmed identical P. aeruginosa strains in both respiratory and biliary samples.
  • The cholangitis and infection remained persistent for 6 months despite intensive antibiotic therapy and drainage.

Implications:

  • Diagnostic procedures like ERCP may pose a risk for introducing respiratory pathogens into the biliary tract in CF patients.
  • This case highlights the challenges in eradicating P. aeruginosa infections in the biliary system of CF patients.
  • Further research into preventative strategies and treatment protocols for biliary infections in CF is warranted.

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