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An unusual case of endotipsitis: persistent infection and migration to the right atrium of a transjugular intrahepatic portosystemic shunt (TIPS)

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Abstract

Endotipsitis is an underdiagnosed entity mainly because it requires a high initial level of suspicion. It should be considered in the differential diagnosis of persistent bacteremia in the cirrhotic patient with TIPS. Most cases are treated conservatively with a long-term antibiotherapy, due to the impossibility of surgical removal of the TIPS, except in a liver transplant or autopsy. The patient we present had endotipsitis that manifested as persistent bacteremia with thrombosis of the TIPS. Initially, conservative management with intravenous antibiotherapy was performed; however, due to mechanical complications caused by migration of the original endoprosthesis, it was decided to perform surgery.

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Authors and Affiliations

  1. Infectious Diseases Department, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Av/Reyes Católicos nº2, 28040, Madrid, Spain

    Silvia Calpena-Martínez, Nerea Carrasco-Antón, Alfonso Cabello-Úbeda & Elizabet Petkova-Saiz

  2. Nephrology Department, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain

    Catalina Cleary-Martín

  3. Cardiovascular Surgery Department, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain

    Rafael Hernández-Estefanía

  4. Clinical Microbiology Department, IIS-Fundación Jiménez Díaz, UAM. CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain

    Jaime Esteban

Authors
  1. Silvia Calpena-Martínez
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  2. Nerea Carrasco-Antón
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  3. Catalina Cleary-Martín
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  4. Rafael Hernández-Estefanía
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  5. Jaime Esteban
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  6. Alfonso Cabello-Úbeda
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  7. Elizabet Petkova-Saiz
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by S.C., E.P., and N.C. The first draft of the manuscript was written by S.C. and E.P. and was reviewed by C.C. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Silvia Calpena-Martínez.

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Ethics approval and consent to participate

The study was carried out in accordance with the recommendations contained in the Declaration of Helsinki and revised at successive world assemblies. Obtaining informed consent is not appropriate given that it is a retrospective study that has not interfered in clinical practice, without identification of personal data.

Competing interests

The authors declare no competing interests.

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Calpena-Martínez, S., Carrasco-Antón, N., Cleary-Martín, C. et al. An unusual case of endotipsitis: persistent infection and migration to the right atrium of a transjugular intrahepatic portosystemic shunt (TIPS). Eur J Clin Microbiol Infect Dis 43, 623–626 (2024). https://doi.org/10.1007/s10096-023-04742-2

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  • DOI: https://doi.org/10.1007/s10096-023-04742-2

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