title: [Proceedings could be dangerous! An endocarditis clinical case].
abstract: BACKGROUND
  The authors describe a clinical case of infective endocarditis after a transrectal proceeding. Following that some questions were made: Which are the updated guidelines? Which are the risk proceedings?
  
  
  METHODS
  A 55-year-old man, with aortic/pulmonary vavuloplasties and haemorrhoids developed an infectious endocarditis, by Streptococcus Viridans, after a rigid proctosigmoidoscopy. Following the endocarditis the patient suffered a pleuritis and pneumonia, those health problems justified 7 months in hospital.
  
  
  CONCLUSIONS
  The case was a co-guiltiness clinical problem which needs a multidisciplinary discussion (cardiologists, general practioners and physicians whose make invasive proceedings). The International Guidelines, with C level of evidence, omitted some potential invasive examinations and treatments so those need to be clarified. In patients with Infective Endocarditis high risk, who had haemorrhoids, before transrectal proceedings antibiotic prophylaxis may be considered.
authors.affiliation: Centro de Saúde do Lumiar, Lisboa, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dias
authors.forename: Paula
authors.initials: P
authors.lastname: Broeiro
mesh_terms: D004697:Endocarditis, Bacterial / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012812:Sigmoidoscopy / Q000009:adverse effects*; D013290:Streptococcal Infections / Q000209:etiology*; D034363:Viridans Streptococci