Q: 44 year old male is admitted to ICU with fever, sepsis and get diagnosed with acute cholingitis. GI service has been called for emergent endoscopic retrograde cholangiopancreatography (ERCP). Which one request you will make to GI service while performing ERCP?


Answer: To send cultures obtained from bile (or stents) removed at  ERCP to help direct antibiotic therapy. E. coli is the most common bug followed by Klebsiella and Enterobacter species. 



Reference: 

1. Negm AA, Schott A, Vonberg RP, et al. Routine bile collection for microbiological analysis during cholangiography and its impact on the management of cholangitis. Gastrointest Endosc 2010; 72:284.