A case of bacterial endocarditis caused by ERCP.

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A 47-year-old male patient was diagnosed as having chronic alcoholic pancreatitis with ERCP and other examinations. On the ninth day after ERCP, he developed fever of higher than 39 degrees. Vegetation at the posterior cups of the mitral valve was disclosed by echocardiography, and Streptococcus faecalis grew in the hemoculture, leading to a diagnosis of bacterial endocarditis. He was successfully treated through intravenous administration of Ampicillin (ABPC). This particular case was complicated by the fact that the patient had acquired mitral insufficiency, which seemed to have induced bacter-emia subsequent to ERCP and to have led to bacterial endocarditis. Upon examination of 28 patients for bactemia by hemocultures following ERCP, no bacteria were detected in any cases. In many other reports, bacteremia was considered a transitory condition, or infection was so slight that it rarely developed into a clinical problem. However, patients with congenital heart diseases, acquired valvular diseases, and immunodef iciency as well as those with artif ical valves are subjected to paticular risks of serious bacterial endocarditis and sepsis. Thus, it is suggested that a prophylactic antibi-otic regimen mainly with Ampicillin should be done soon after endoscopic examinations.
社団法人日本消化器内視鏡学会の論文