[Splenic abscesses: From diagnosis to therapy].

Area of Science:

• Infectious Diseases
• Abdominal Imaging
• Surgical Management

Background:

• Splenic abscess is an uncommon septic collection, often affecting males and immunocompromised individuals.
• No established guidelines exist for the diagnosis and management of splenic abscess.
• It arises from hematogenous spread or local dissemination.

Purpose of the Study:

• To review current literature on splenic abscesses.
• To cover diagnosis, management, and therapeutic strategies.
• To discuss the controversial role of splenectomy in preventing recurrence.

Main Methods:

• Literature review of splenic abscesses.
• Analysis of diagnostic modalities, including computed tomography (CT) scans and blood cultures.
• Evaluation of treatment approaches, including antibiotics and drainage techniques.

Main Results:

• Computed tomography (CT) scans demonstrate high sensitivity (95%) and specificity (92%) for diagnosis.
• Blood cultures are positive in 24-80% of cases; abscess cultures post-drainage are more efficient (50-80%).
• Commonly involved microorganisms include enterobacteriaceae, gram-positive cocci, and anaerobes, necessitating broad-spectrum antibiotics.

Conclusions:

• Management mirrors that of liver abscesses, typically involving antibiotics and drainage.
• The efficacy of splenectomy for preventing recurrence remains debated.
• Early and accurate diagnosis via CT and appropriate antimicrobial therapy are crucial.