Splenic abscess - An old disease with new interest

Background/Aims: To study the demographics, signs and symptoms, causes, ris k factors, imaging findings, bacteriologic profile, treatment and outcome o f patients with splenic abscess. Method: The medical records of 17 patients with splenic abscess at two tertiary-care hospitals between 1989 and 1997 were retrospectively reviewed. The demographic data, physical and radiologi cal findings, treatment, bacteriology reports and outcome of treatment were reviewed. Results: The mean age of patients was 43 years (range 7-79 years ). Fever and abdominal pain were the most prominent signs. Seven patients w ere immunocompromised, three had abscessed hydatic cysts, two were drug use rs and three suffered from splenic trauma, infarction, and endocarditis, re spectively. No predisposing factor was identified in 2 patients. In all cas es, CT demonstrated the splenic lesion(s). Staphylococcus species and Bacte riodes were the most common microbes, identified in the blood and abscess c ultures. Thirteen patients underwent splenectomy, two medical therapy and t wo no therapy with respective survival rates of 92, 100 and 0%. Conclusion: Splenic abscess is a rare surgical entity encountered mostly in immunocomp romised patients. CT scan is the gold standard for the definite diagnosis. Splenectomy is the treatment of choice, while medical therapy should be res erved for unusual pathogens provided that an effective antimicrobial agent is available. Copyright (C) 2000 S. Karger G, Basel.