Bacteremia associated with extracorporeal shockwave lithotripsy of gallbladder stones.
OBJECTIVE
The possible induction of bacteremia by extracorporeal shock wave lithotripsy (ESWL) of gallbladder stones was studied.


METHODS
Seventy-six patients undergoing a total of 107 ESWL treatments were studied.


RESULTS
Twenty-four (22%) of the 107 treatments were associated with bacteremia. Staphylococcus epidermidis was cultured during and/or after 23 (96%) of the treatments associated with bacteremia. The ESWL-induced tissue damage of the skin in the pass-way of the shock-waves was the most likely cause of bacteremia in these patients. There was no correlation between the occurrence of bacteremia and the age or body mass index of the patients. Neither was there any correlation of bacteremia related to the duration of the treatment, the number of shock waves, the energy delivered, the stone volume or the occurrence of calcified stones. No patient developed sepsis or endocarditis. Transient fever shortly after treatment was recorded in 5 patients (5%), one of whom had bacteremia.


CONCLUSIONS
Routine antibiotic prophylaxis is not indicated in patients undergoing ESWL for gallbladder stones. The question whether such prophylaxis should be given to patients at special risk, for instance patients with artificial heart valves or known valvular heart disease, remains to be answered in larger controlled and randomized studies.
Kullman
E
E
Department of Surgery, University Hospital, Linköping, Sweden.
Jönsson
K A
KA
Lindström
E
E
Dahlin
L G
LG
Ansehn
S
S
Borch
K
K
D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D016022:Case-Control Studies; D002769:Cholelithiasis / Q000628:therapy*; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D013212:Staphylococcus epidermidis