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Splenic volume in severe sepsis is associated with disease severity and pneumococcal infection
Yasutaka Koga1, Motoki Fujita2, Takashi Nakahara1
1Advanced Medical Emergency and Critical Care Center Yamaguchi University Hospital Ube Yamaguchi Japan.
Aim:
A small spleen, which is occasionally found in patients with pneumococcal sepsis, may increase pneumococcal susceptibility because of splenic malfunction. However, a small spleen may also originate from severe disease. We carried out a retrospective study to evaluate the association between splenic volume and severe pneumococcal sepsis or disease severity.
Methods:
We reviewed the medical records of 23 patients with severe pneumococcal sepsis treated at our institution between January 2004 and September 2015 (pneumococcal group) and 61 patients with severe non-pneumococcal bacteremia treated between April 2011 and September 2015 (control group). Splenic volume measured by abdominal computed tomography on admission was compared between the two groups. Correlations between Acute Physiology and Chronic Health Evaluation (APACHE) II scores and splenic volume on admission and the change in splenic volume from the non-septic state to admission were also determined.
Results:
Splenic volume on admission was significantly smaller (P = 0.001) and a small spleen was more frequent (P < 0.001) in the pneumococcal group. The APACHE II score was negatively correlated with splenic volume on admission (r = -0.46, P < 0.001) and the change in splenic volume (r = -0.44, P = 0.004). Pneumococcal infection (odds ratio 13.1, 95% confidence interval 2.6-65.7; P = 0.002) and APACHE II score (odds ratio 1.2, 95% confidence interval 1.1-1.3; P = 0.002) were independently associated with small spleen.
Conclusion:
Splenic volume decreased with increasing severity of severe sepsis. A small spleen was also associated with severe pneumococcal infection.
Insights
A small spleen is linked to severe pneumococcal infections. Spleen size decreases with sepsis severity, indicating a potential role in disease progression and susceptibility.
Area of Science:
- Medical Science
- Infectious Diseases
- Radiology
Background:
- A small spleen is occasionally observed in pneumococcal sepsis patients.
- Splenic malfunction may increase susceptibility to pneumococcal infections.
- Severe illness can also lead to a smaller spleen size.
Purpose of the Study:
- To investigate the association between splenic volume and severe pneumococcal sepsis.
- To evaluate the relationship between splenic volume and overall disease severity.
Main Methods:
- Retrospective study comparing 23 patients with severe pneumococcal sepsis and 61 with severe non-pneumococcal bacteremia.
- Splenic volume measured by abdominal computed tomography (CT) on admission.
- Correlations analyzed between Acute Physiology and Chronic Health Evaluation (APACHE) II scores and splenic volume.
Main Results:
- Patients with pneumococcal sepsis had significantly smaller splenic volume on admission (P = 0.001).
- A small spleen was more frequent in the pneumococcal group (P < 0.001).
- APACHE II scores negatively correlated with splenic volume (r = -0.46, P < 0.001).
Conclusions:
- Splenic volume diminishes with increasing severity of severe sepsis.
- A small spleen is independently associated with severe pneumococcal infection and higher APACHE II scores.
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