PT  - JOURNAL ARTICLE
AU  - Andrei Schwartz
AU  - Aayushi Garg
AU  - Giselle Statz
AU  - Justin Smock
TI  - Endotipsitis: a rare case of endovascular infection with ESBL <em>Klebsiella pneumoniae</em>
AID  - 10.1136/bcr-2019-233972
DP  - 2020 Apr 01
TA  - BMJ Case Reports
PG  - e233972
VI  - 13
IP  - 4
4099  - http://casereports.bmj.com/content/13/4/e233972.short
4100  - http://casereports.bmj.com/content/13/4/e233972.full
SO  - BMJ Case Reports2020 Apr 01; 13
AB  - Endotipsitis is a vegetative endovascular infection of a transjugular intrahepatic portosystemic shunt (TIPS). There is currently no uniformly accepted diagnostic criterion, and most cases are diagnosed by clinical diagnosis of recurrent bacteraemia in patients with TIPS and no identifiable source after appropriate investigation. We present a case of 62-year-old man in whom endotipsitis was suspected clinically after emergent TIPS placement complicated by TIPS thrombosis, need for TIPS revision and recurrent bacteraemia. The diagnosis was confirmed using an Indium-111-labelled leucocyte scan (tagged white blood cell scan). This case highlights the potential risks of endotipsitis with TIPS procedures and provides insight into the utilisation of an old diagnostic tool in a new diagnostic role.