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Canadian Journal of Infectious Diseases
Volume 1, Issue 4, Pages 143-145
Case Report

Enterococcus Faecalis Endocarditis Following Percutaneous Manipulation of a Biliary Tract Calculus and ERCP

Allan R Ronald and Andrew LS Pattullo

Department of Infectious Diseases and Medical Microbiology, Health Sciences Center Hospital, Winnipeg, Manitoba, Canada

Received 30 April 1990; Accepted 20 August 1990

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A case of Enterococcus faecalis endocarditis followed endoscopic retrograde cholangiopancreatography and percutaneous extraction of a biliary calculus is reported. The most likely cause of endocarditis, though unproven, is the latter procedure, as the bile is often infected during biliary tract obstruction, and bacteremia is frequent during percutaneous manipulations. Initial therapy with vancomycin was unsuccessful in clearing the bacteremia, possibly due to vancomycin tolerance of the isolate and lack of an aminoglycoside in the initial regimen. Cure was obtained when therapy with ampicillin and gentamicin was undertaken.