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Recurrent Klebsiella pneumoniae Bacteremia Due to Endotipsitis
Scott Everett1, Andrew L Alejo1, Katherine I Tatar2
1College of Medicine, Northeast Ohio Medical University, Rootstown, USA.
Abstract:
Transjugular intrahepatic portosystemic shunt (TIPS) procedures are commonly performed in patients with cirrhosis to decrease the pressure in the portal system. An unusual complication of this procedure is endotipsitis, an infection of the shunt/stent with resultant sustained bacteremia caused by vegetation within the TIPS. The most commonly associated pathogens include staphylococci, enterococci, streptococci, and enteric Gram-negative bacilli. We present a patient who developed endotipsitis due to Klebsiella pneumoniae and presented with refractory K. pneumoniae bacteremia. Our patient had a progressively worsening clinical picture and after recognition of endotipsitis was transferred to another facility for liver transplantation and removal of the TIPS. Rapid diagnosis of endotipsitis in the setting of refractory bacteremia is essential to patient survival.
Insights
Endotipsitis, an infection of transjugular intrahepatic portosystemic shunt (TIPS), can cause persistent bacteremia. Early diagnosis of this rare TIPS complication is crucial for patient survival.
Area of Science:
- Interventional Cardiology
- Infectious Diseases
- Hepatology
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) is a common procedure for managing portal hypertension in cirrhosis.
- Endotipsitis, an infection of the TIPS device, is an uncommon but serious complication.
- Commonly implicated pathogens include staphylococci, enterococci, streptococci, and Gram-negative bacilli.
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