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A case of splenic abscess during treatment of interstitial pneumonia

Koichi Izumikawa1, Yoshitomo Morinaga, Kinichi Izumikawa

  • 1Department of Internal Medicine, Izumikawa Hospital, Nagasaki 859-1504, Japan. koizumik@nagasaki-u.ac.jp

Japanese Journal of Infectious Diseases
|October 25, 2006
PubMed

Insights

A splenic abscess caused by methicillin-resistant Staphylococcus aureus (MRSA) in an immunocompromised patient was successfully treated with vancomycin alone. This case highlights a potential non-surgical treatment option for splenic abscesses in select patients.

Area of Science:

  • Infectious Diseases
  • Radiology
  • Pulmonology

Background:

  • Corticosteroids and immunosuppressive therapy for interstitial pneumonia can increase the risk of opportunistic infections.
  • Splenic abscesses are rare but serious complications, often requiring invasive procedures for treatment.
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen, particularly in healthcare-associated infections.

Observation:

  • Incidental finding of splenic abscess-like lesions on chest computed tomography (CT) in a patient treated for interstitial pneumonia.
  • Isolation of MRSA from ultrasonography-guided percutaneous aspiration of the splenic lesion.
  • Patient had a history of intermittent MRSA colonization in sputum and risk factors for bloodstream infection (central venous catheter, intubation).

Findings:

  • Successful non-surgical treatment of a splenic abscess using intravenous vancomycin without percutaneous drainage.
  • Demonstrates the potential efficacy of targeted antibiotic therapy in select cases of splenic abscess.
  • Suggests a possible pathway of airway colonization to bloodstream seeding via medical devices.

Implications:

  • Vancomycin may be a viable alternative to drainage for splenic abscesses in immunocompromised patients with MRSA.
  • Highlights the importance of vigilant monitoring for infections in patients receiving immunosuppressive therapy.
  • Emphasizes the need for careful consideration of potential pathogen sources and transmission routes in complex cases.

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