Diagnosis and Treatment of Splenic Abscess (about 11 cases)

Abstract

AIM: To describe the clinical features, etiology, imaging findings, bacteriologic profile, treatment and outcome in patients presenting splenic abscess in a Tunisian hospital. METHODS: It is a retrospective study, where we reviewed 11 splenic abscess cases that were hospitalized between January, 1st 2000 and October, 31st 2009. RESULTS: Eleven cases (5 males, 6 females) were found., the mean age was 59 years. Fever was found in 7 cases, the left-upper-quadrant guarding was found in 6 cases, splenomegaly was found in 2 cases were the main clinical signs. Laboratory tests revealed leukocytosis and elevated level of CRP in all cases. All patients were investigated by ultrasound and CT scan.The primary site of infection was found In 3 cases, (endocarditis and urinary infection). There was one case of epithelial cyst of the spleen that was secondarily infected and in the other 7 cases the etiology was not found; it was about primary spleen damage.Treatment was essentially surgical (total splenectomy) except for one case which was treated medically (antibiotics) and successfully. The outcome was generally favorable with the exception of two deaths from septic shock (originating from a urinary infection) CONCLUSION: . The abscess of the spleen is a rare condition. Its clinical expression is highly polymorphic. Its positive diagnosis is based on imaging; the diagnosis must be made in good time to ensure timely treatment, which may be medical, interventional or surgical. The outcome after treatment is usually favorable.