Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2022; 10(31): 11652-11657
Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11652
Unexplained septic shock after colonoscopy with polyethylene glycol preparation in a young adult: A case report
Jiao-Jiao Song, Chen-Jiao Wu, Yuan-Yuan Dong, Can Ma, Qing Gu
Jiao-Jiao Song, Chen-Jiao Wu, Yuan-Yuan Dong, Can Ma, Qing Gu, Department of Gastrointestinal Endoscopy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Song JJ and Gu Q contributed to manuscript writing and editing; Wu CJ and Dong YY contributed to data collection; Ma C contributed to conceptualization and supervision; all authors read and approved the final manuscript
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing Gu, MSc, Chief Nurse, Gastrointestinal Endoscopy, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 21318037@zju.edu.cn
Received: July 31, 2022
Peer-review started: July 31, 2022
First decision: September 5, 2022
Revised: September 15, 2022
Accepted: September 27, 2022
Article in press: September 27, 2022
Published online: November 6, 2022
Processing time: 88 Days and 2.5 Hours
Abstract
BACKGROUND

Colonoscopy has become a routine physical examination as people’s health awareness has increased. Polyethylene glycol (PEG) is greatly used in bowel preparation before colonoscopy due to its price and safety advantages. Septic shock after colonoscopy with PEG preparation is extremely rare, with only very few cases in critically ill patients. Herein, we describe a case of septic shock in a healthy young adult immediately following colonoscopy with PEG preparation.

CASE SUMMARY

A 33-year-old young adult presented to our hospital for colonoscopy with PEG bowel preparation due to recurrent diarrhea for 7 years. The male's previous physical examination showed no abnormal indicators, and colonoscopy results were normal; however, he exhibited septic shock and markedly elevated white blood cell, C-reactive protein, and procalcitonin levels on the second day after colonoscopy. Immediate resuscitation and intensive care with appropriate antibiotics improved his condition. However, the blood and stool cultures did not detect the pathogen

CONCLUSION

Septic shock after colonoscopy is rare, especially in young adults. The authors considered the possibility of opportunistic infections after PEG bowel preparation, and clinicians should monitor patients for the possibility of such complications

Keywords: Septic shock; Polyethylene glycol; Colonoscopy; Case report

Core Tip: We describe a case of septic shock with markedly elevated white blood cell, C-reactive protein, and procalcitonin levels in a 33-year-old healthy young adult immediately following colonoscopy with polyethylene glycol (PEG) preparation. Analysis of the cases indexed in PubMed in addition to this case report indicates that septic shock after colonoscopy is rare, especially in healthy young adults. The authors considered the possibility of opportunistic infections after PEG bowel preparation, and clinicians should monitor patients for the possibility of such complications. Aggressive treatment can rapidly improve patient symptoms