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. 2024 Mar;43(3):623-626. doi: 10.1007/s10096-023-04742-2. Epub 2024 Jan 17.

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.

Keywords: Bacteremia; Endotipsitis; Migration; Right atrium; TIPS.

Publication types

  • Case Reports

MeSH terms

  • Bacteremia*
  • Heart Atria
  • Humans
  • Liver Transplantation* / adverse effects
  • Persistent Infection
  • Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects