Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Yonsei Med J. 2021 Feb;62(2):182-186. doi: 10.3349/ymj.2021.62.2.182.
Fever is a common complication of endoscopic variceal obturation (EVO) therapy for gastric variceal bleeding. However, fungemia related to EVO therapy has not yet been reported. Herein, we report two cases of post-EVO fungemia in cirrhotic patients who underwent therapeutic EVO for gastric variceal bleeding. Both patients developed sustained high fever after repeated EVO procedures while on prophylactic antibiotic use. In both patients, blood cultures revealed yeast, and they were finally diagnosed with infection. is a common member of the intestinal flora; however, it can cause invasive infection with consequent poor prognosis in cirrhotic patients. The route of invasion is unclear; however, repeated EVO may predispose patients to infection, particularly those who are in the end stage of liver disease and receiving prophylactic antibiotics. Our cases highlight that repeated invasive procedures can increase the risk of fungal infections, and fungemia should be considered in the differential diagnosis of post-EVO fever.
发热是内镜下曲张静脉套扎术（EVO）治疗胃静脉曲张出血的常见并发症。然而，与 EVO 治疗相关的真菌血症尚未见报道。在此，我们报告了两例肝硬化患者在接受 EVO 治疗胃静脉曲张出血后发生的 EVO 后真菌血症。这两例患者在预防性使用抗生素的情况下，在重复 EVO 手术后持续高热。两例患者的血培养均显示为酵母菌，最终诊断为感染。是肠道菌群的常见成员；然而，它可引起侵袭性感染，导致肝硬化患者预后不良。感染途径尚不清楚；然而，反复 EVO 可能使患者易感染，尤其是那些处于肝病终末期且接受预防性抗生素治疗的患者。我们的病例强调了重复的侵袭性操作会增加真菌感染的风险，对于 EVO 后发热，应考虑真菌血症的鉴别诊断。
