The Annals of Thoracic Surgery, Vol 30, 19-23, Copyright © 1980 by The Society of Thoracic Surgeons
Bacteremia after esophageal dilation: a clinical and experimental study
ES Golladay, JJ Tepas 3d, LR Pickard, JJ Seibert, RW Brown and JA Haller Jr
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.