A transjugular intrahepatic portosystemic shunt (TIPS) may be placed to relieve portal hypertension in a patient with cirrhosis. The shunt may become infected, resulting in endo-TIPS-itis.
Patient selection: portal hypertension with TIPS
Causative organisms:
(1) Enterobacteriaceae
(2) other bacteria
(3) Candida species
(4) other fungi
Clinical features:
(1) intermittent or persistent bacteremia or fungemia
(2) fever
(3) possible pulmonary micro-emboli
(4) anemia
(5) leukocytosis
Imaging studies may show vegetations and/or thrombi associated with the TIPS.
The diagnosis may be made after exclusion of other identifiable sources.
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