title: Occurrence of infective endocarditis following endoscopic variceal ligation therapy: A case report.
abstract: BACKGROUND
  Endoscopic variceal ligation (EVL) is the endoscopic treatment of acute esophageal variceal hemorrhage, however, prophylaxis antibiotic during EVL is controversial.
  
  
  METHODS
  We reported a 60-year-old man with diabetes, liver cirrhosis and hepatocellular carcinoma who received EVL for esophageal variceal haemorrhage.
  
  
  RESULTS
  On the second day after EVL, the patient developed fever and chills. A week after EVL, the blood cultures were viridans streptococcus positive, and echocardiogram showed a vegetation on the cardiac valve. The patient was therefore diagnosed with infective endocarditis (IE). The patient was cured after 7 weeks of intravenous piperacillin sulbactam sodium. No complications were observed during the 3-month follow-up after discharge.
  
  
  CONCLUSIONS
  To our knowledge, this is the first documented case to report IE caused by viridans streptococcus after EVL. Therefore, whether prophylaxis antibiotic should be administered to cirrhotic patients receiving EVL is worth further research.
authors: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors: Xuan
authors: X
authors: Zhang
authors: Xiaoli
authors: X
authors: Liu
authors: Meifang
authors: M
authors: Yang
authors: Huihui
authors: H
authors: Dong
authors: Lichen
authors: L
authors: Xv
authors: Lanjuan
authors: L
authors: Li
mesh_terms: D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections; D034363:Viridans Streptococci