Endotipsitis: An Underdiagnosed Complication of Transjugular Intrahepatic Portosystemic Shunts

Niyas, Vettakkara Kandy Muhammed; Keri, Vishakh C; Kumar, Prabhat

doi:10.1016/j.jceh.2021.02.009

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…Whenever endotipsitis is suspected, the workup should start with a color Doppler ultrasound to evaluate TIPS patency, along with the exclusion of all other possible sources of bacteremia [ 10 ]. An indium-111-labeled leukocyte (WBC) scan can also assist by demonstrating increased leukocyte uptake around the TIPS [ 11 ]. The gold standard method for the diagnosis of endotipsitis involves removing the TIPS and culturing it; however, this is not feasible without a concomitant liver transplant [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Endotipsitis in an Immunocompetent Patient With Lactobacillus Bacteremia

Shareef¹,

Khan²,

Shahid³

et al. 2023

Cureus

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Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure commonly performed to decompress portal venous pressure since the early 1990s. Endotipsitis, which refers to persistent bacteremia caused by endovascular infection of the TIPS stent, is a rare but serious complication of this procedure. Very few cases of endotipsitis have been reported worldwide. We report the case of an immunocompetent patient diagnosed with endotipsitis, an atypical risk factor for Lactobacillus infection. This case report adds to the literature on underreported complications of TIPS, highlighting an urgent need for introducing clinical practice guidelines regarding the definition, diagnosis, and treatment of endotipsitis.

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Section: Discussionmentioning

confidence: 99%

“…Antibiotic therapy is recommended for approximately six weeks with repeat blood cultures to ensure early resolution of bacteremia [ 11 ]. In patients with continued bacteremia despite being on appropriate antibiotics, extraction of TIPS via liver transplant should be considered [ 13 ].…”

Section: Discussionmentioning

confidence: 99%