What is the infection risk of oesophageal dilatations?
Oesophageal dilatation is the most widely used treatment option for the management of oesophageal strictures. Complications include bleeding, a slight increase in body temperature, thoracic or abdominal pain, oesophageal perforation, brain abscess and bacteraemia. We performed a prospective study to evaluate the frequency of post-dilatation bacteraemia in nine patients subjected to a total of 50 dilatations. Bacteraemia was detected in 36 cases (72%), In all but three cases, however, it was transient and not associated with fever or other clinical complications. The organisms most commonly responsible (64%) were alpha-haemolytic streptococci (Streptococcus viridans), probably originating as contaminants from the oropharynx and oesophagus and introduced into the bloodstream during dilatation. Despite the relatively low incidence of bacteraemia-related postdilatation complications, the potential severity of such complications argues for the use of antibiotic prophylaxis as a routine measure prior to oesophageal dilatation.


CONCLUSIONS
Oesophageal dilatation is associated with a high incidence of bacteraemia. The organisms most commonly responsible were alpha-haemolytic streptococci. We recommend the use of antibiotic prophylaxis as a routine measure prior to oesophageal dilatation.
Bautista-Casasnovas
A
A
Servicio de Cirugía Pediátrica, Complejo Hospitalario Universitario de Santiago, Santiago of Compostela, Spain. pdbautis@uscmail.usc.es
Varela-Cives
R
R
Estévez Martínez
E
E
Jardón Bahía
J A
JA
Barca
P R
PR
Dargallo Carbonell
T
T
Villanueva Jeremias
A
A
Cadranel
S
S
Tojo
R
R
D016470:Bacteremia / Q000209:etiology*; D002057:Burns, Chemical / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004106:Dilatation / Q000009:adverse effects*; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies