Cho SY, Cho E, Park CH, Kim HJ, Koo JY. Septic shock due to Granulicatella adiacens after endoscopic ultrasound-guided biopsy of a splenic mass: A case report. World J Gastroenterol 2021; 27(8): 751-759 [PMID: 33716452 DOI: 10.3748/wjg.v27.i8.751]
Corresponding Author of This Article
Eunae Cho, MD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju 61469, South Korea. cea202@cnuh.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 28, 2021; 27(8): 751-759 Published online Feb 28, 2021. doi: 10.3748/wjg.v27.i8.751
Septic shock due to Granulicatella adiacens after endoscopic ultrasound-guided biopsy of a splenic mass: A case report
Seo-Yeon Cho, Eunae Cho, Chang-Hwan Park, Hee-Joon Kim, Joo-Yeon Koo
Seo-Yeon Cho, Eunae Cho, Chang-Hwan Park, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, South Korea
Hee-Joon Kim, Department of Surgery, Chonnam National University Hospital, Gwangju 61469, South Korea
Joo-Yeon Koo, Department of Pathology, Chonnam National University Hospital, Gwangju 61469, South Korea
Author contributions: Cho SY contributed to analysis and interpretation of the data and drafting of the article; Park CH, Kim HJ and Koo JY contributed to technical and material support; Cho E contributed to critical revision and final approval of this article.
Informed consent statement: The study participant provided informed consent for this manuscript and its publication.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eunae Cho, MD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, 42 Jebong-ro, Donggu, Gwangju 61469, South Korea. cea202@cnuh.com
Received: November 23, 2020 Peer-review started: November 23, 2020 First decision: December 21, 2020 Revised: January 18, 2021 Accepted: February 11, 2021 Article in press: February 11, 2021 Published online: February 28, 2021
Abstract
BACKGROUND
Endoscopic ultrasound-guided fine needle aspiration or biopsy (EUS-FNA or FNB) has become a popular method for diagnosing various lesions of the gastrointestinal tract and surrounding tissue due to the accuracy and safety. To the best of our knowledge, no case report of severe infection after EUS-FNB of a solid lesion in the spleen has been described. Herein, we report a rare case of septic shock after EUS-FNB of a splenic mass.
CASE SUMMARY
A 45-year-old male patient presented to the outpatient clinic due to an incidentally detected splenic mass. A definitive diagnosis could not be established based on the abdominal magnetic resonance imaging. EUS of the spleen showed a 6 cm-sized, relatively well-demarcated, heterogeneous mass, and EUS-FNB with a 22G needle was performed. Ten days after the procedure patient developed septic shock and a splenic abscess was identified. Blood culture revealed growth of Granulicatella adiacens. After the treatment with antibiotics the patient underwent surgical resection, and the pathological examination showed diffuse large B-cell lymphoma. The patient received chemotherapy and he is in complete remission.
CONCLUSION
Infection of a splenic mass after EUS-FNB is a rare complication and prophylactic antibiotics might be considered.
Core Tip: As the risk of infection after endoscopic ultrasound (EUS)-guided sampling of a solid organ is very low, prophylactic antibiotics are generally not recommended. However, our patient developed an abscess after EUS-guided fine needle biopsy of a splenic tumor. To the best of our knowledge, this is the first case of septic shock after EUS-guided fine needle biopsy of a splenic large B cell lymphoma and of an infection caused by Granulicatella adiacens during this procedure. Therefore, we suggest considering prophylactic antibiotic usage for EUS-guided sampling of splenic tumors.
