A case of escherichia coli endocarditis after hemorrhoidectomy performed by a herbalist

Amaç: Herbalist tarafından gerçekleştirilen hemoroidektomi sonrası Escherisia Coli endokarditi geçiren bir hasta tanımlanmıştır.Gereç ve yöntemler: Bir üniversite hastanesi erişkin yoğun bakım ünitesinde septik şok ve karın ağrısı ile takip edilen olgunun sunumu.Bulgular: Bu olguda hemoroidektomi sonrası karın ağrısı ve septik şokla gelen hastanın kan kültüründe pan- sensitif Esherichia coli ve Citrobacter amalonaticus üremiştir. Ampisillin/sulbaktam ve gentamisin tedavisi başlanmıştır. Yapılan transözafagial eko sonrasında protez aort kapağı çevresinde halkalar halinde abse odalkarı görülmüştür. Hasta operasyona alınarak yeni bir St. Jude aort kapağı ile değiştirilmiştir. Patoloji sonucu akut ve organize eksudalar içeren endokardit gelmiş ve değişen aort kapağı kültüründe E. Coli üremiştir. Postoperatif beş haftalık intravenöz antibiyotik uygulanması sonucunda hasta taburcu edilmiştir. Sonuç: Herbal tedavi sonuçları ve komplikasyonları konusunda hekimler daha fazla bilgi sahibi olmalıdırlar. Kolorektal cerrahi için antibiyotik kullanımı mutlaka insizyon öncesi başlanmalı ve 24 saat süreyle devam edilmelidir.

Herbalist tarafından yapılan hemoroidektomi sonrası gelişen Escherichia coli endokarditi vakası

We describe the first reported case of Escherichia coli endocarditis following a hemorrhoidectomy that was performed by the patient's herbalist. With increasing frequency, patients are seeking care by those who practice alternative medicine. Physicians must become more aware of the impact and possible complications related to this practice. Prosthetic valve endocarditis ranges up to 1.5% per patient-year for mechanical mitral valves and up to 0.1% per patient-year for other valves. Although the incidence of aortic prosthetic valve endocarditis is not uncommon, the concomitant organism and its mode of bacteremia make this a most unusual case. There is a paucity of information in the literature regarding surgical complications performed by alternative medicine practitioners. To our knowledge, a case of gram-negative endocarditis as a result of hemorrhoidectomy performed by an herbalist has never been reported.

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