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Abstract
BackgroundPolyethylene glycol (PEG) is widely used for bowel cleaning in preparation for colonoscopy because of its safety. Septic shock after PEG preparation is an extremely rare complication. Herein, we describe a case of septic shock that occurred immediately after colonoscopy preparation with PEG.Case presentationA 75-year-old Japanese male who had previously developed diabetes after total pancreatectomy received PEG in preparation for colonoscopy. He had been admitted to the emergency intensive care unit 4 days earlier due to hematochezia presenting with shock. He ingested PEG to prepare for a colonoscopy examination, which was performed to identify the source of his bleeding over a 5-h period, but suddenly exhibited septic shock and markedly elevated procalcitonin levels. A blood culture subsequently revealed Citrobacter braakii. Immediate resuscitation and intensive care with appropriate antibiotics improved his condition.ConclusionsClinicians should be aware of the possibility of deteriorating conditions after bowel preparation with PEG among severely ill patients with recent episodes of hemorrhagic shock.
Highlights
Polyethylene glycol (PEG) is widely used for bowel cleaning in preparation for colonoscopy because of its safety
Clinicians should be aware of the possibility of deteriorating conditions after bowel preparation with PEG among severely ill patients with recent episodes of hemorrhagic shock
We describe a case of septic shock due to C. braakii bacteremia that occurred immediately after colonoscopy preparation with PEG in an adult patient who had recently suffered an episode of hemorrhagic shock
Summary
We reported a case of C. braakii bacteremia-induced septic shock that occurred immediately after PEG ingestion for colonoscopy preparation. Clinicians should be aware of the life-threatening complications of bowel preparation with PEG in such critically ill patients. Authors’ contributions TY, YK, SK, CK, AI, KS, and TU cared for the patient. HO, YU, and AN evaluated the draft and suggested revisions. All authors read and approved the final manuscript. Author details 1 Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, 2‐5‐1 Kita‐ku, Shikata‐cho, Okayama‐shi, Okayama 700‐8558, Japan
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