Peritoneal infection and bacteraemia following endoscopic injection sclerotherapy

ABSTRACT

Peritoneal infection and bacteraemia following endoscopic injection sclerotherapy [EIS] were studied in 30 patients presenting with liver cirrhosis, ascites and oesophageal haemorrhage. Blood and ascitic fluid samples were collected for cultures just before and 24 hours after EIS. They were cultivated both aerobically and anaerobically at 37degree. Eight patients [22%] developed bacteraemia while six other patients developed peritoneal infection [20%] following EIS. Higher rates of bacteraemia and peritoneal infection were found in patients with advanced liver disease. Staph aureus [4 cases], Strept viridans [2 cases], Staph. epidermidis [1 case] and C. haemolyticum [1 case] were isolated from cases with bacteraemia. While, E. coil [3 cases], klebsiella [2 cases] and Candida albicans [1 case] were isolated from ascitic fluid cultures. None of the patients with positive ascitic fluid cultures had any clinical evidence of peritoneal infection. Accordingly a high index of suspicion is important in order to diagnose cases with peritoneal infection following oesophageal endoscopic sclerotherapy even in absence of clinical evidence of infection with special emphasis on patients with grade [c] liver cirrhosis