Citrobacter braakii bacteremia-induced septic shock after colonoscopy preparation with polyethylene glycol in a critically ill patient: a case report

Ann Clin Microbiol Antimicrob. 2017 Apr 4;16(1):22. doi: 10.1186/s12941-017-0201-5.

Abstract

Background: Polyethylene glycol (PEG) is widely used for bowel cleaning in preparation for colonoscopy because of its safety. Septic shock after PEG preparation is an extremely rare complication. Herein, we describe a case of septic shock that occurred immediately after colonoscopy preparation with PEG.

Case presentation: A 75-year-old Japanese male who had previously developed diabetes after total pancreatectomy received PEG in preparation for colonoscopy. He had been admitted to the emergency intensive care unit 4 days earlier due to hematochezia presenting with shock. He ingested PEG to prepare for a colonoscopy examination, which was performed to identify the source of his bleeding over a 5-h period, but suddenly exhibited septic shock and markedly elevated procalcitonin levels. A blood culture subsequently revealed Citrobacter braakii. Immediate resuscitation and intensive care with appropriate antibiotics improved his condition.

Conclusions: Clinicians should be aware of the possibility of deteriorating conditions after bowel preparation with PEG among severely ill patients with recent episodes of hemorrhagic shock.

Keywords: Case report; Citrobacter braakii; Colonoscopy; Polyethylene glycol; Septic shock.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Asian People
  • Blood / microbiology
  • Citrobacter / isolation & purification*
  • Critical Illness
  • Enterobacteriaceae Infections / chemically induced*
  • Enterobacteriaceae Infections / complications*
  • Humans
  • Male
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects*
  • Shock, Septic / etiology*
  • Shock, Septic / pathology*

Substances

  • Polyethylene Glycols