Infectious complications of endoscopic injection sclerotherapy

We prospectively assessed the infectious complications of esophageal injection sclerotherapy (EIS) in 38 patients who underwent 104 procedures. Blood cultures were taken prior to and five and ten minutes after injection of the sclerosing agent in all procedures in an attempt to determine the frequency of positive blood cultures. Surveillance cultures were obtained from each patient's pharynx and from the biopsy channel of the endoscope to identify potential sources of bacteremia. The rate of blood culture positivity before injection was not significantly different from that after injection (1.9% vs 4.3%). In only one procedure was the same organism isolated five and ten minutes after sclerotherapy. The isolate in both samples was a Corynebacterium species. Endoscope surveillance cultures were positive prior to 42 of 102 procedures, although none of those organisms subsequently were isolated in the blood cultures. Since the rate of positive blood cultures following EIS is no greater than that before the procedure, the use of prophylactic antibiotics is unnecessary.