Gastrointestinal procedures have been associated with a wide range of infectious complications, including bacterial endocarditis. Although the rate of bacteremia from the patient's own flora is quite high after some procedures, only a few cases of endocarditis caused by gastrointestinal instrumentation have been reported. Because of the severity of the illness, however, antibiotic prophylaxis has been recommended for patients who are categorized as high risk for some procedures. Bacteremia and other infections, such as colitis, may also originate from a contaminated endoscope. To prevent such an occurrence, high-level disinfection has been recommended for gastrointestinal endoscopes. High-level disinfection includes manual cleaning of the endoscope, flushing of internal channels with a liquid chemical sterilant, and thorough rinsing and drying of internal lumens.