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[Abscess of the spleen]
Nikica Grubor1, Radoje Colović, Natasa Colović
1Institute of Digestive System Diseases, Clinical Centre of Serbia, Belgrade.
Srpski Arhiv Za Celokupno Lekarstvo
|August 2, 2005
Summary
Splenic abscess, though rare, is increasing. This study highlights splenectomy combined with antibiotics and underlying disease management as the preferred treatment for splenic abscess, with conservative antibiotic therapy reserved for select cases.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Medical Imaging
Context:
- Splenic abscess is an uncommon but increasingly recognized clinical entity.
- This study reviews 9 cases treated between 1986 and 2004.
- Etiologies included septic endocarditis, trauma, dental infections, and chemotherapy for myeloproliferative disorders.
Purpose:
- To analyze the clinical presentation, diagnostic methods, causative agents, and treatment outcomes of splenic abscess.
- To evaluate the efficacy of different therapeutic strategies, including surgery and antibiotics.
Summary:
- Nine patients with splenic abscess presented with fever, abdominal pain, and shoulder pain. Diagnostic imaging, particularly CT scans, proved crucial for identifying abscesses.
- Commonly isolated pathogens included Enterococcus, Streptococcus, Staphylococcus, E. coli, Salmonella, and Candida albicans.
- Eight patients underwent splenectomy, with one treated successfully with high-dose antibiotics. One patient mortality was attributed to pre-existing septic endocarditis.
Impact:
- The findings underscore the importance of prompt diagnosis and aggressive management for splenic abscess.
- Splenectomy coupled with appropriate antibiotic therapy and management of the underlying condition is recommended as the gold standard treatment.
- Conservative antibiotic management should be considered only for carefully selected patients.