Bacteremia and local infections with nasal packing.

Microbiological examination of the blood and nose was performed on 33 patients hospitalized with posterior epistaxis in order to determine the incidence of bacteremia and local bacterial growth associated with nasal packing. A local antibiotic regimen of oxytetracycline and polymyxin B was also evaluated. Two fairly distinct patterns of bacterial growth from the nose emerged. A single microorganism, most commonly gram-positive, was isolated from the nose of the patients treated with the local antibiotic regimen. Multiple gram-positive and gram-negative bacteria were found on nasal culture from patients without local antibiotics. Incidence of bacteremia was 12%; clinical septicemia and death occurred once. Lack of attention to these infectious complications of nasal packing could lead to serious additional morbidity.