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Ann Thorac Surg 1980;30:19-23
© 1980 The Society of Thoracic Surgeons

Articles

Bacteremia after Esophageal Dilation: A Clinical and Experimental Study

E.S. Golladay, M.D.*, J.J. Tepas, III, M.D., L.R. Pickard, M.D., J.J. Seibert, M.D., R.W. Brown, M.D., J. Alex Haller, Jr., M.D.

From the Departments of Surgery, Radiology, and Pathology, University of Arkansas Medical Sciences Campus and Arkansas Children's Hospital, Little Rock, AR, and the Division of Pediatric Surgery, the Johns Hopkins Hospital, Baltimore, MD

Accepted for publication November 9, 1979.

* Address reprint requests to Dr. Golladay, Chief of Surgery, Arkansas Children's Hospital, 804 Wolfe St, Little Rock, AR 72201

Patients with esophageal stricture caused by caustic ingestion, reflux esophagitis, or esophageal anastomosis often require repeated dilation. These patients frequently have a short febrile course after dilation. After development of brain abscess following esophageal dilation in 1 patient, positive blood cultures were obtained in 4 patients immediately following esophageal dilation. Caustic strictures were produced in cats and esophageal dilations performed. Blood cultures were positive at one minute after dilation in 6 cats and at five minutes in 2 of those cats. The organism responsible in all clinical and three of four experimental examples was Staphylococcus aureus. It is suggested on the basis of this clinical and experimental data that patients undergoing esophageal dilation should have prophylactic coverage if they are immunosuppressed, if endocarditis prophylaxis is necessary, if they are infants, if they are diabetic, or if they had severe bacteremia following dilation.




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