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Splenic abscess associated with endocarditis.

S L Robinson1, J M Saxe, C E Lucas

  • 1Departments of Surgery, Wayne State University, Detroit, Mich. 48201.

Surgery
|October 1, 1992
PubMed
Summary
This summary is machine-generated.

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Splenic abscesses can complicate endocarditis, leading to persistent sepsis. Early diagnosis via CT scan and prompt splenectomy significantly improve survival rates in these critical patients.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Abdominal Surgery

Background:

  • Refractory or recurrent sepsis in endocarditis patients can stem from splenic abscess.
  • Assessing the relationship between endocarditis and splenic abscess is crucial for patient management.

Purpose of the Study:

  • To evaluate the association between endocarditis and the development of splenic abscess.
  • To determine the diagnostic accuracy of imaging modalities and the efficacy of treatment strategies.

Main Methods:

  • Retrospective review of 564 patients with endocarditis (1970-1990).
  • Analysis of 27 patients who developed splenic abscesses, including demographics, etiology, symptoms, and valve involvement.
  • Evaluation of diagnostic imaging (CT scan) and treatment outcomes (splenectomy, valvular surgery).

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Main Results:

  • Splenic abscesses occurred in 27 of 564 endocarditis patients.
  • Computed axial tomography (CT) scans had variable accuracy in diagnosing splenic abscess.
  • Mortality was significantly lower in patients treated with splenectomy (3/17 deaths) compared to those without (10/10 deaths).

Conclusions:

  • Splenic abscess is a recognized complication of endocarditis.
  • Diagnosis is aided by refractory fever and confirmed with abdominal CT scans.
  • Splenectomy, often in conjunction with or after valvular surgery, is a critical intervention for improving survival.