Abstract
Background/Purpose Splenic abscess is rare with potentially life-threatening evolution. The aim of this study is to review the clinical features, microbiological etiologies, treatment, and outcomes of patients with splenic abscess. Methods We reviewed the admitted patients with suspected splenic abscess and made the diagnosis of splenic abscess. The clinical characteristics, underlying diseases, treatment course, organism spectra, abscess number and size, therapeutic methods, and clinical outcome at a tertiary medical center in Taiwan over a period of 5 years were analyzed. Results Of 16 patients with splenic abscess, the male to female ratio was 1 : 1. Common presentations were fever (11 patients, 68.7%), diffuse abdominal pain (6 patients, 37.5%), left upper quadrant pain or tenderness (6 patients, 37.5%), and left-sided pleural effusions (8 patients, 50%). Antimicrobial therapy was administered in all patients. Fourteen (87.5%) patients recovered under medical treatment. One (6.2%) patient underwent splenectomy, four (25%) patients performed percutaneous drainage of their splenic abscess, and 11 (68.7%) patients received antimicrobial therapy alone. Conclusion We noted that mortality may be more related to patients with underlying immunodeficiency. Patients with splenic abscesses receiving antimicrobial therapy alone were in a relatively high proportion and got a good prognosis especially in patients with small and multiple abscesses.
Highlights
Splenic abscess is an uncommon infection. e incidence of splenic abscess in autopsy studies is estimated to be 0.05– 0.7% [1, 2]
Inclusion criteria of this study were as follows: (1) histological results of the resected splenic tissue showed the Canadian Journal of Infectious Diseases and Medical Microbiology presence of an abscess, (2) causative pathogens were isolated from a splenic aspirate or blood culture with compatible imaging studies of computed tomography (CT) or US, (3) splenic abscesses were found during exploratory laparotomy, or (4) clinical manifestations were consistent with imaging findings and there was an improvement in the patient’s clinical condition after antimicrobial therapy
One hundred and four patients with a diagnosis of splenic abscess were reviewed between January 2012 and December 2016, and 16 patients met the criteria for splenic abscess. e male to female ratio was 1 : 1, with a mean age of 49.9 years
Summary
Splenic abscess is an uncommon infection. e incidence of splenic abscess in autopsy studies is estimated to be 0.05– 0.7% [1, 2]. E incidence of splenic abscess in autopsy studies is estimated to be 0.05– 0.7% [1, 2]. Hematogenous spread is the most common cause of splenic abscess. It typically results from endocarditis or seeding from some contiguous sites of infection [3, 4]. E management of splenic abscesses includes medical therapy, CT-guided percutaneous aspiration, and splenectomy. Recent studies have stressed the changing clinical spectrum and indicated that intravenous antimicrobial therapy alone for patients with splenic abscess showed better outcome [2, 6, 7]. E aim of the study was to review the clinical features, microbiological etiologies, treatment, and outcomes of patients with splenic abscess over the previous 5 years Recent studies have stressed the changing clinical spectrum and indicated that intravenous antimicrobial therapy alone for patients with splenic abscess showed better outcome [2, 6, 7]. e aim of the study was to review the clinical features, microbiological etiologies, treatment, and outcomes of patients with splenic abscess over the previous 5 years
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