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Splenic Abscess
Aka: Splenic Abscess, Spleen Abscess
- Causes
- Bacteremia including Endocarditis
- Staphylococcus aureus
- Streptococcus
- Bartonella (Cat Scratch Disease)
- Contiguous spread from intra-abdominal infection or peritonitis
- Polymicrobial infections
- Immunocompromised patients
- Candida (Candidemia)
- Other causes seen in Southeast Asia
- Klebsiella
- Burkholderia pseudomallei
- Symptoms
- Fever
- Left Upper Quadrant Abdominal Pain
- Labs
- Complete Blood Count
- Leukocytosis
- Imaging
- CT Abdomen and Pelvis
- Differential Diagnosis
- Splenic Infarction (CT findings are similar)
- 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
- Prognosis
- Mortality approaches 70% in delayed diagnosis and 80% in Immunocompromised patients
- Resourves
- Splenic Abscess (Stat Pearls)
- https://www.ncbi.nlm.nih.gov/books/NBK519546/
- References
- (2019) Sanford Guide, accessed on IOS 2/3/2020
- Lee (2018) Can J Infect Dis Med Microbiol +PMID: 29666665 [PubMed]
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5830950/