Open AccessEndotipsitis: a rare case of endovascular infection with ESBL Klebsiella pneumoniae
Author(s) -
A. Schwartz,
Aayushi Garg,
Giselle M. Statz,
Justin Smock
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-233972
Subject(s) - medicine , klebsiella pneumoniae , rare disease , transjugular intrahepatic portosystemic shunt , radiology , thrombosis , surgery , cirrhosis , portal hypertension , disease , biochemistry , chemistry , escherichia coli , gene
Endotipsitis is a vegetative endovascular infection of a transjugular intrahepatic portosystemic shunt (TIPS). There is currently no uniformly accepted diagnostic criterion, and most cases are diagnosed by clinical diagnosis of recurrent bacteraemia in patients with TIPS and no identifiable source after appropriate investigation. We present a case of 62-year-old man in whom endotipsitis was suspected clinically after emergent TIPS placement complicated by TIPS thrombosis, need for TIPS revision and recurrent bacteraemia. The diagnosis was confirmed using an Indium-111-labelled leucocyte scan (tagged white blood cell scan). This case highlights the potential risks of endotipsitis with TIPS procedures and provides insight into the utilisation of an old diagnostic tool in a new diagnostic role.