Gastroenterology Book

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Splenic Abscess

Aka: Splenic Abscess, Spleen Abscess
  1. Causes
    1. Bacteremia including Endocarditis
      1. Staphylococcus aureus
      2. Streptococcus
      3. Bartonella (Cat Scratch Disease)
    2. Contiguous spread from intra-abdominal infection or peritonitis
      1. Polymicrobial infections
    3. Immunocompromised patients
      1. Candida (Candidemia)
    4. Other causes seen in Southeast Asia
      1. Klebsiella
      2. Burkholderia pseudomallei
  2. Symptoms
    1. Fever
    2. Left Upper Quadrant Abdominal Pain
  3. Labs
    1. Complete Blood Count
      1. Leukocytosis
  4. Imaging
    1. CT Abdomen and Pelvis
  5. Differential Diagnosis
    1. Splenic Infarction (CT findings are similar)
  6. Management
    1. Surgery Consultation for possible Splenectomy
      1. May also consider percutaneous abscess aspiration in high risk surgical patients
    2. Empiric antibiotic selection depends on suspected source
      1. Bacteremia including Endocarditis (Streptococcus, Staphylococcus)
        1. Vancomycin if MRSA suspected (or e.g. Nafcillin if MSSA)
      2. Contiguous spread from intra-abdominal infection or peritonitis (Polymicrobial infections)
        1. Piperacillin-Tazobactam (Zosyn)
      3. Immunocompromised patients (Candidiasis)
        1. Fluconazole or Caspofungin or Amphoteracin B
  7. Prognosis
    1. Mortality approaches 70% in delayed diagnosis and 80% in immunocompromised patients
  8. Resourves
    1. Splenic Abscess (Stat Pearls)
      1. https://www.ncbi.nlm.nih.gov/books/NBK519546/
  9. References
    1. (2019) Sanford Guide, accessed on IOS 2/3/2020
    2. Lee (2018) Can J Infect Dis Med Microbiol +PMID: 29666665 [PubMed]
      1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5830950/

Splenic abscess (C0272412)

Concepts Disease or Syndrome (T047)
ICD10 D73.3
SnomedCT 82053000
Italian Ascesso della milza
Japanese 脾臓膿瘍, ﾋｿﾞｳﾉｳﾖｳ
English splenic abscess (diagnosis), splenic abscess, abscesses spleen, spleen abscess, abscess spleen, Splenic abscess, Abscess of spleen, Splenic abscess (disorder), spleen; abscess, Splenic Abscess
Czech Absces sleziny
Korean 지라의 고름집(농양)
Hungarian splenicus tályog
Dutch milt; abces, Miltabces, miltabces
Spanish absceso del bazo, absceso esplénico (trastorno), absceso esplénico, Absceso esplénico
Portuguese Abcesso esplénico
French Abcès splénique
German Abszess der Milz
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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