{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:02:06Z","timestamp":1784721726278,"version":"3.55.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Endoscopic retrograde cholangiopancreatography is crucial for treating pancreaticobiliary diseases with biliary stones, but it can lead to serious complications, including severe systemic sepsis. Sepsis is a life-threatening critical condition. The 1\u202fh bundle recommended by the Surviving Sepsis Campaign remains the core strategy for early management. Although the 2021 and 2026 Surviving Sepsis Campaign guidelines have adopted a stratified approach to antibiotic timing in non-shock patients, personalized early intervention is crucial for high-risk critically ill individuals. We present a 76-year-old female with cholecystolithiasis complicated by choledocholithiasis who developed\n                    <jats:italic>Aeromonas hydrophila<\/jats:italic>\n                    sepsis following Endoscopic Retrograde Cholangiopancreatography stone extraction and laparoscopic cholecystectomy. Within a span of 10\u202fh, the patient\u2019s white blood cell count experienced a significant decline, accompanied by increased levels of inflammatory biomarkers and a Sequential Organ Failure Assessment score of 2. The 1\u202fh sepsis bundle was promptly implemented, including blood culture, lactate measurement, intravenous fluid resuscitation, and empirical meropenem. Blood culture identified\n                    <jats:italic>Aeromonas hydrophila<\/jats:italic>\n                    infection, and targeted antimicrobial therapy was administered. The patient achieved favorable recovery with no recurrence at 2-month follow-up. To our knowledge, this is the first reported case of\n                    <jats:italic>Aeromonas hydrophila<\/jats:italic>\n                    sepsis after combined endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Personalized 1\u202fh bundle implementation is vital to optimize prognosis in high-risk patients. This case also highlights the importance of strict adherence to endoscope reprocessing protocols, routine quality monitoring, and water quality management to minimize procedure-related infection risks.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1883706","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:12:03Z","timestamp":1784718723000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Aeromonas hydrophila sepsis after ERCP and laparoscopic cholecystectomy: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Jinli","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengting","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengxiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"An","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjie","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baifa","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]},{"name":"Department of General Surgery, The General Hospital of Western Theater Command","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1055\/a-0862-0346","article-title":"Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) 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