Fatal septic shock after fine needle aspiration of a pancreatic pseudocyst.

Fatal septic shock due to Streptococcus sanguis developed eight days after fine needle aspiration (FNA) of a pancreatic pseudocyst. The pseudocyst was adherent to the transverse colon (as is often the case with pseudocysts), and contamination of cyst fluid with colonic bacteria most likely initiated the infection. The patient had not received prophylactic antibiotics, even though the needle had been observed to pass through the bowel at the time of the CAT-scan-guided aspiration. Although the literature documents the safety and usefulness of FNA in the diagnosis of pancreatic tumors, this case suggests that prophylactic antibiotics be considered at the time of aspiration of pseudocysts or necrotic tumors.