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Infective endocarditis from Enterococcus faecalis complicating colonoscopy in Heyde’s syndrome

Department of Internal Medicine, Università "La Sapienza", Rome, Italy

Correspondence to:
Correspondence to:
Dr Sergio Morelli
Department of Internal Medicine, Università "La Sapienza", Viale del Policlinico 155, 00161 Rome, Italy; sergio.morelli{at}uniroma1.it

A case of infective endocarditis from Enterococcus faecalis after colonoscopy in a patient with aortic stenoinsufficiency and bleeding intestinal angiodysplasia (Heyde’s syndrome) is reported.

A 77 year old man with aortic stenoinsufficiency presented with enterorrhagia and underwent a colonoscopy, which showed normal findings. Fifteen days later he developed a moderate degree of fever. Blood cultures were positive for E faecalis. An echocardiogram showed aortic valve vegetations, and infective endocarditis was diagnosed and successfully treated by antibiotics. Some months later, intestinal bleeding recurred and intestinal resection was performed. Histopathology showed angiodysplasia.

In patients with Heyde’s syndrome antibiotic prophylaxis should be considered before colonoscopy.

Keywords: gastrointestinal angiodysplasia; aortic stenosis; infective endocarditis; Enterococcus faecalis; colonoscopy