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Volume 47, Number 2, April 2014

Splenic abscesses at a tertiary medical center in northern Taiwan 


Yi-Hsiu Liu, Chang-Pan Liu, Chun-Ming Lee


Received: April 27, 2012    Revised: August 2, 2012    Accepted: August 24, 2012   

 

Corresponding author:

Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital, Taipei, Taiwan
Mackay Medicine, Nursing and Management College, Taipei, Taiwan
Taipei Medical University, Taipei, Taiwan
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
Corresponding Author InformationCorresponding author. Division of Infectious Disease, Department of Medicine, Mackay Memorial Hospital, 92, Section 2, Zhongshan North Road, Zhongshan District, Taipei City 104, Taiwan, ROC. 



 

Background and purpose: 

Splenic abscesses are uncommon. This study aimed at assembling the demographics, clinical features, microbiologic etiologies, imaging, treatments, and outcomes of patients with splenic abscesses at a tertiary medical center in northern Taiwan. 



 

Methods:

The diagnosis of splenic abscess was made either by imaging studies associated with clinical symptoms and signs of infection, or by imaging studies associated with microbiological data or pathologic results. The clinical characteristics, isolated pathogens, and treatments diagnosed at a medical center in northern Taiwan between 2000 and 2011 were analyzed retrospectively.
 



 

Results:

Of 28 patients with splenic abscess, male patients accounted for 46% of the study population. The mean age of the patients at the time of presentation was 46.5 years (range 4 months to 85 years). Common presentations were fever (71.4%, 20 cases), abdominal pain (46.4%, 13 cases), cough or dyspnea (35.7%, 10 cases), splenomegaly (32.1%, 9 cases), and left-sided pleural effusion (32.1%, 9 cases). Leukocytosis was noted in 22 patients (78.5%). Gram-negative bacilli and Gram-positive cocci were cultivated from six patients (21%). No specific pathogen was predominant in patients with splenic abscesses. The overall mortality was 14.3%, while the mortality among the patients treated with antimicrobial therapy alone was 5.6%. 



 

Conclusion:

The survival rate was high in patients with splenic abscesses who received antimicrobial therapy alone. Percutaneous drainage can be used as an alternative choice for patients with severe co-morbidities or patients who are critically ill. 



 

Key words:

Percutaneous drainage, Splenic abscess, Treatment