Analysis of clinical characteristics of 26 patients with melioiclosis spleen abscesses in Hainan province

Abstract

Objective To analyze the clinical features of melioidosis spleen abscess. Methods A retrospective analysis of 26 cases with melioidosis spleen abscess at Hainan People′s Hospital between October 2002 and March 2015 was performed. Data with general conditions, clinical characteristics, imaging features, treatment and outcome were all extracted and analyzed. Results High fever (100.0%) and splenomegaly (73.1%) were the main clinical symptoms and signs. Laboratory examinations showed that white blood cell and neutrophil percentage increased, with a mean value of 12.6×109/L and 0.86, respectively. 88.5% cases had diabetes mellitus which was the main underlying disease. Apart from spleen abscess, pulmonary infection (73.1%) and liver abscess (38.5%) were the majority. Imaging showed multiple small abscess (92.3%). All patients had at least one positive blood culture of Burkholderia pseudomallei and were treated with imipenem, ceftazidime and sulfamethoxazole alone or in combination. Hospitalization days ranged between 8 to 65 days with the mean of 29.5 days. Twenty-three cases (88.5%) were cured, the remaining 3 cases (11.5%) abandoned treatment and were all lost for follow-up. Conclusions Melioidosis should be suspected in patients from epidemic areas, who have diabetes and imaging shows spleen abscess and other organ infections including pulmonary infection and liver abscess. Microbiological culture is needed immediately. Key words: Melioidosis; Spleen abscess; Hainan