Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2022; 14(4): 846-853
Published online Apr 27, 2022. doi: 10.4254/wjh.v14.i4.846
Late polymicrobial transjugular intrahepatic portosystemic shunt infection in a liver transplant patient: A case report
Irene Caridad Perez, Ziv J Haskal, John I Hogan, Curtis K Argo
Irene Caridad Perez, Department of Medicine, University of Virginia Medical Center, Charlottesville, VA 22903, United States
Ziv J Haskal, Department of Radiology and Medical Imaging, Division of Vascular and Interventional Radiology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
John I Hogan, Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia Medical Center, Charlottesville, VA 22903, United States
Curtis K Argo, Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia Medical Center, Charlottesville, VA 22903, United States
Author contributions: Perez IC was the internal medicine resident physician providing care during initial hospitalization; Perez IC also drafted and participated in the revision process and final submission of this manuscript; Haskal ZJ was the interventional radiologist that performed the procedures described in this case and participated in the whole revision process; Hogan JI was the infectious disease specialist overseeing her care and participated in the whole revision process; Argo CK was the outpatient and inpatient hepatologist who provided specialized care, participated in the revision process and final submission of this manuscript.
Informed consent statement: Consent was obtained verbally over the phone from the husband as the patient passed away.
Conflict-of-interest statement: Dr. Haskal disclosures include working with Varian, Boston Scientific, WL Gore and Associates, and Becton Dickinson. All other authors have no actual or potential conflicting interest in the submission of this manuscript.
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: Curtis K Argo, MD, MS, Associate Professor, Doctor, Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia Medical Center, 1215 Lee St, Charlottesville, VA 22903, United States. cka3d@hscmail.mcc.virginia.edu
Received: July 30, 2021
Peer-review started: July 30, 2021
First decision: September 29, 2021
Revised: October 8, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 27, 2022
Core Tip

Core Tip: Polymicrobial transjugular intrahepatic portosystemic shunt (TIPS) infection may occur in an immunocompromised patient many years following TIPS creation. Given the high morbidity and mortality associated with TIPS infection, it is important to consider this diagnosis early in a patient with recurrent septicemia, even without recent TIPS creation or revision. Early shunt thrombectomy is important for source control and optimization of antibiotic penetrance of the TIPS.