Bacteremia after endoscopic injection sclerosis

Endoscopic injection sclerosis is a therapeutic alternative in the management of esophageal varices. Complications of sclerotherapy have been minor, including fever, bacteremia, and abnormal chest x-ray. We performed a prospective study to evaluate the frequency of postsclerosis bacteremia. Bacteremia was detected in 14 procedures (50%). There were no cases of bacteremia in a group of control patients with esophageal varices undergoing upper gastrointestinal endoscopy without sclerosis (p < 0.05). Bacteremia was transient and unrelated to the presence of fever or other clinical complications. The organism most commonly cultured from blood, α-hemotytic streptococcus, probably represents a contaminant from the oropharynx, introduced into the bloodstream during sclerosis. We conclude that injection sclerotherapy of esophageal varices is associated with a higher incidence of bacteremia than routine upper endoscopy and that selected patients may require antibiotic prophylaxis when undergoing this procedure.