II. Causes
- Bacteremia including Endocarditis
- Contiguous spread from intra-abdominal infection or peritonitis
- Polymicrobial infections
-
Immunocompromised patients
- Candida (Candidemia)
- Other causes seen in Southeast Asia
- Klebsiella
- Burkholderia pseudomallei
III. Symptoms
IV. Labs
V. Imaging
VI. Differential Diagnosis
- Splenic Infarction (CT findings are similar)
VII. Management
- Surgery Consultation for possible Splenectomy
- May also consider percutaneous abscess aspiration in high risk surgical patients
- Empiric Antibiotic selection depends on suspected source
- Bacteremia including Endocarditis (Streptococcus, Staphylococcus)
- Vancomycin if MRSA suspected (or e.g. Nafcillin if MSSA)
- Contiguous spread from intra-abdominal infection or peritonitis (Polymicrobial infections)
- Piperacillin-Tazobactam (Zosyn)
- Immunocompromised patients (Candidiasis)
- Fluconazole or Caspofungin or Amphoteracin B
- Bacteremia including Endocarditis (Streptococcus, Staphylococcus)
VIII. Prognosis
- Mortality approaches 70% in delayed diagnosis and 80% in Immunocompromised patients
IX. Resourves
- Splenic Abscess (Stat Pearls)
X. References
- (2019) Sanford Guide, accessed on IOS 2/3/2020
- Lee (2018) Can J Infect Dis Med Microbiol +PMID: 29666665 [PubMed]