Experience with Splenic Abscess from Southern India

Abstract

Introduction: Splenic abscess is a rare entity with potentially life threatening complications. Sparse recent published data are available documenting the aetiological profile and management of patients with splenic abscess from India. Aim: To study the clinical profile of splenic abscess. Materials and Methods: We retrospectively collected data from case records of admitted patients with splenic abscesses, to Nizam’s Institute of Medical Sciences and Hospital which is a multispecialty, tertiary care referral hospital over a period of 15 months (from March 2014 to May 2015) and parameters studied were age, sex, symptoms, signs, risk factors, investigations like Ultrasound, CT scan, blood & microbiological culture, treatment and outcome. Results: Most common presenting symptom was fever (90%). Mean age was 33.5 years. Five patients (55%) had risk factors like HIV, leukaemia and diabetes. From pus culture Escherichia coli was the most common organism (22%) grown. Staphylococcus saureus, Enterococcus faecium were seen in one each, blood culture grown Cryptococcus neoformans, Pseudomonas aeroginosa in one each, Plasmodium falciparum was seen on peripheral smear in one. Three were empirically treated as disseminated koch’s. Another was treated as possible infective endocarditis. All were given antimicrobials, five (55%) were treated with antimicrobials alone, three (33%) with PCD (Per Cutaneous Drainage) and one (11%) with subtotal splenectomy. All patients recovered. Conclusion: With early diagnosis and increased use of ultrasound guided procedures like aspiration or drainage, spleenectomy can be avoided. Optimal treatment for splenic abscess is yet to be defined and customized to each patient.

Keywords

• percutaneous drainage
• mortality
• spleenectomy