Bacteremia after nasal surgery

ABSTRACT

Bacteremia is often harmless, but not in subjects at high risk of cardiovascular lesions. The risk factor depends on the frequency of bacteremia and the involved microorganism. To determine this factor, 50 patients were managed by nasal surgery. Thirty of them with CS were operated upon by functional endoscopic sinus surgery [FESS], Caldwell-Iuc operation, and intra-nasal antrostomy according to clinical and radiological findings. The other twenty patients were operated upon by septoplasty or rhinoplasty according to each indication. Preoperative nasal swabs and peri-operative blood cultures were done according to conventional methods. The cultures of nasal swabs were positive in 90% of cases and were polymicrobial with prevalence of anaerobes. All the pre-operative blood cultures were negative, while it was positive in post-operative blood cultures in 25% of cases operated upon by Caldwell-Iuc operation, and 10% in cases operated upon by intranasal antrostomy. Postoperative blood cultures of patients operated upon by FESS or septorhinoplasty were negative. The difference [in our opinion] may be due to compromised vascular tree for each technique, and the amount of manipulation and tissue destruction. According to this study, we can postulate that bacteremia is an avoidable complication by selection of surgical techniques with minimal manipulation like FESS, and knowledge of bacteria involved in bacteremia is of value in choosing first-line antibiotic if symptoms arise