Splenic abscesses at a tertiary medical center in Northern Taiwan

Splenic abscesses are uncommon. This study aimed at assembling the demographics, clinical features, microbiologic etiologies, imaging, treatments, and outcomes of patients with splenic abscesses at a tertiary medical center in northern Taiwan.

The diagnosis of splenic abscess was made either by imaging studies associated with clinical symptoms and signs of infection, or by imaging studies associated with microbiological data or pathologic results. The clinical characteristics, isolated pathogens, and treatments diagnosed at a medical center in northern Taiwan between 2000 and 2011 were analyzed retrospectively.

Of 28 patients with splenic abscess, male patients accounted for 46% of the study population. The mean age of the patients at the time of presentation was 46.5 years (range 4 months to 85 years). Common presentations were fever (71.4%, 20 cases), abdominal pain (46.4%, 13 cases), cough or dyspnea (35.7%, 10 cases), splenomegaly (32.1%, 9 cases), and left-sided pleural effusion (32.1%, 9 cases). Leukocytosis was noted in 22 patients (78.5%). Gram-negative bacilli and Gram-positive cocci were cultivated from six patients (21%). No specific pathogen was predominant in patients with splenic abscesses. The overall mortality was 14.3%, while the mortality among the patients treated with antimicrobial therapy alone was 5.6%.

The survival rate was high in patients with splenic abscesses who received antimicrobial therapy alone. Percutaneous drainage can be used as an alternative choice for patients with severe co-morbidities or patients who are critically ill.