This case report highlights the potential risk of enterococcal endocarditis following routine sigmoidoscopy in patients with mitral valve prolapse, contributing to the debate on antimicrobial prophylaxis.
Does not support changing MVP prophylaxis; leaves open whether sigmoidoscopy warrants targeted prevention studies.
There is considerable controversy regarding antimicrobial prophylaxis against infective endocarditis for routine sigmoidoscopy without biopsy in patients with underlying valvular heart disease. Sigmoidoscopy is known to produce brief, low-grade bacteremia in some patients. Persons with mitral valve prolapse (MVP) may be at risk of infective endocarditis developing during transient bacteremia. We describe a 67-year-old man with known MVP in whom enterococcal endocarditis developed following routine sigmoidoscopy. We believe this to be the first such reported case.
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John Rigilano (1984) studied this question.
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