2003 Volume 23 Issue 7 Pages 1069-1073
A 65-year-old man with liver cirrhosis underwent high anterior resection for sigmoid colon cancer. On postoperative day 9, he developed a high-grade fever with severe chills, and Enterobacter aerogenes was detected in a peripheral blood specimen. Because there was no evidence of leakage peritonitis, bacterial translocation (BT) was highly suspected as the cause of the bacteremia. After treatment by selective digestive decontamination (SDD) plus systemic antibiotics, the patient's condition improved and he was discharged on postoperative day 21. He was re-admitted because of adhesion ileus one month after the operation, and was treated conservatively. One day after admission, he developed a high-grade fever, and Enterobacter cloacae was detected in both peripheral blood and small intestinal fluid specimens. BT was strongly suspected, and SDD was performed again, resulting in a good, prompt response. Our case suggests that patients with cirrhosis are susceptible to BT and that SDD may be a useful therapeutic strategy against BT.
