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Recurrent methicillin-resistant Staphylococcus aureus septicaemia and pacemaker-lead-associated endocarditis following diagnostic gastroscopy
  1. Debabrata Majumdar1,
  2. Jyothi G Rao2,
  3. Kapil Kapur1,
  4. Basil T Saeed3,
  5. Ashraf Soliman1
  1. 1Department of Gastroenterology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
  2. 2Department of Microbiology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
  3. 3Department of Cardiology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
  1. Correspondence to Dr Ashraf Soliman, Department of Gastroenterology, Barnsley District General Hospital NHS Foundation Trust, Gawber Road, Barnsley S75 2EP, UK; a.soliman{at}nhs.net

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We read with interest the recent guidelines for antibiotic prophylaxis produced by the British Society of Gastroenterology which do not support the routine use of antibiotic prophylaxis even for high-risk patients having an endoscopy.1 We would like to present a case which suggests that these guidelines may be underplaying the possible risk in certain patients.

We experienced a 67-year-old patient with recurrent Methicillin resistant Staphylococcus aureus (MRSA) septicaemia due to pacemaker-lead endocarditis, as a complication of a gastroscopy. He had a past medical history of coronary artery bypass grafting and permanent pacemaker implant, and was admitted with a 2-day history of melaena. A day after endoscopy, he developed features of sepsis, complicated by ventricular tachyarrythmia necessitating treatment in the intensive care unit. Blood cultures were positive for MRSA, …

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