Successful Conservative Management of a Large Splenic Abscess Secondary to Infective Endocarditis

Area of Science:

• Infectious Diseases
• Abdominal Surgery
• Sepsis Management

Background:

• Splenic abscesses are often caused by septic emboli from infective endocarditis.
• Standard treatment includes splenectomy or image-guided drainage.
• The natural history of untreated splenic abscesses is not well understood.

Observation:

• A patient with aortic valve infective endocarditis developed a large, complex splenic abscess.
• Previous abdominal surgery with synthetic mesh precluded further abdominal interventions.
• The splenic abscess was treated conservatively with antibiotics only.

Findings:

• The splenic abscess resolved completely with antibiotic therapy alone.
• No recurrence of infection was observed during a 3-year follow-up period.
• Conservative management proved successful in this complex case.

Implications:

• Antibiotic monotherapy may be a viable option for splenic abscesses in select patients.
• This approach can avoid surgical morbidity, especially in patients with contraindications to surgery.
• Further research into the natural history and conservative management of splenic abscesses is warranted.