Enterococcal endocarditis following sigmoidoscopy and mitral valve prolapse.

There is considerable controversy regarding antimicrobial prophylaxis against infective endocarditis for routine sigmoidoscopy without biopsy in patients with underlying valvular heart disease. Sigmoidoscopy is known to produce brief, low-grade bacteremia in some patients. Persons with mitral valve prolapse (MVP) may be at risk of infective endocarditis developing during transient bacteremia. We describe a 67-year-old man with known MVP in whom enterococcal endocarditis developed following routine sigmoidoscopy. We believe this to be the first such reported case.