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Splenic abscess complicating infectious endocarditis.

J D Johnson, M J Raff, P A Barnwell

    Archives of Internal Medicine
    |May 1, 1983
    PubMed
    Summary
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    Infective endocarditis frequently leads to splenic abscess. Prompt diagnosis and surgical intervention, alongside antibiotics, significantly improve survival rates for patients with this serious condition.

    Area of Science:

    • Infectious Diseases
    • Abdominal Surgery

    Background:

    • Infective endocarditis is a primary risk factor for splenic abscess.
    • Splenic abscesses are rare but serious complications, often associated with specific bacterial pathogens.

    Purpose of the Study:

    • To review the clinical characteristics, diagnosis, and management of splenic abscess in patients with infective endocarditis.
    • To identify key indicators for early diagnosis and effective treatment strategies.

    Main Methods:

    • Retrospective review of 37 patients with splenic abscess and a history of infective endocarditis.
    • Analysis of clinical symptoms, physical findings, diagnostic imaging, and treatment outcomes.

    Main Results:

    • Streptococci, enterococci, and staphylococci were the most common causative agents.

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  • Key symptoms included abdominal distention, pain, and fever; left-sided pleural effusion was a frequent radiographic finding.
  • Splenectomy combined with antibiotics demonstrated a high survival rate (19/20), whereas non-surgical management was associated with high mortality.

    • Conclusions:

    • Splenic abscess should be suspected in endocarditis patients, especially with staphylococcal or enterococcal infections.
    • Early diagnostic evaluation, including imaging and potentially laparotomy, is crucial.
    • Aggressive management involving splenectomy and antibiotics is critical for patient survival.