Yumoto Tetsuya, Kono Yoshiyasu, Kawano Seiji, Kamoi Chihiro, Iida Atsuyoshi, Nose Motoko, Sato Keiji, Ugawa Toyomu, Okada Hiroyuki, Ujike Yoshihito, Nakao Atsunori
Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, 2-5-1 Kita-ku, Shikata-cho, Okayama-shi, Okayama, 700-8558, Japan.
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan.
Ann Clin Microbiol Antimicrob. 2017 Apr 4;16(1):22. doi: 10.1186/s12941-017-0201-5.
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.
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.
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.
聚乙二醇（PEG）因其安全性而被广泛用于结肠镜检查前的肠道准备。PEG肠道准备后发生感染性休克是一种极为罕见的并发症。在此，我们报告一例在使用PEG进行结肠镜检查准备后立即发生感染性休克的病例。
一名75岁的日本男性，此前在全胰切除术后患糖尿病，接受PEG进行结肠镜检查准备。他因便血伴休克于4天前入住急诊重症监护病房。他服用PEG准备结肠镜检查，该检查旨在确定其出血源，检查持续了5小时，但他突然出现感染性休克，降钙素原水平显著升高。随后血培养显示为布氏柠檬酸杆菌。立即进行复苏并使用适当抗生素进行重症监护使他的病情得到改善。
临床医生应意识到，近期有出血性休克发作的重症患者在使用PEG进行肠道准备后病情可能恶化。
