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Splenic abscess and infective endocarditis.

Monique Boukobza1, Lionel Rebibo2,3, Emila Ilic-Habensus4

  • 1Department of Radiology, Bichat-Claude Bernard University Hospital, Assistance Publique-Hôpitaux de Paris, 46 Rue Henri Huchard, 75018, Paris, France. m.boukobza@orange.fr.

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Summary
This summary is machine-generated.

Splenic abscesses (SAs) in infective endocarditis (IE) patients often involve Enterococcus faecalis and present with complications like emboli. Early evaluation for splenic abcedation is crucial in IE patients with splenic emboli.

Keywords:
Abdominal-CTInfective endocarditisPET/CTSplenectomySplenic abscessSplenic infarctSplenic infectious aneurysm

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Radiology

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves.
  • Splenic abscesses (SAs) are rare but significant complications of IE.
  • Understanding SA characteristics in IE is vital for diagnosis and management.

Purpose of the Study:

  • To investigate the background, bacteriology, clinical, and radiological features of splenic abscesses in patients with infective endocarditis.
  • To identify associated lesions, treatment strategies, and outcomes for SA in IE.

Main Methods:

  • Retrospective study of 474 patients with definite IE from 2005-2021.
  • Diagnosis of SA in 36 patients (7.6%) confirmed via abdominal CT scans.
  • Analysis of patient demographics, pre-existing conditions, causative organisms, and complications.

Main Results:

  • Common pathogens included Streptococcus spp., Enterococcus faecalis, and Staphylococcus spp.
  • Prevalent comorbidities were diabetes, prosthetic valves, and previous IE.
  • Frequent presentations involved abdominal pain and pleural effusion; common complications included emboli and osteoarticular infections.

Conclusions:

  • Splenic abscesses in IE patients showed higher rates of large vegetations, Enterococcus faecalis, rare pathogens, diabetes, osteoarticular involvement, and cancer compared to non-SA IE patients.
  • Splenic abscesses can arise from splenic infarcts; IE patients with splenic emboli require evaluation for abcedation.
  • Combined cardiac surgery and splenectomy, with cardiac surgery preceding, proved safe.