A retrospective study of clinical, radiological, and microbial profile and outcome in patients with splenic abscess

Abstract

Aim: This study aimed to describe the clinical, radiological, and microbiological profile; treatment; and outcome in splenic abscess. Materials and Methods: This is a retrospective study, in which fifty cases of splenic abscess that were hospitalized between January 1, 2010, and December 31, 2019, were reviewed . Results: A total of fifty cases (36 males and 14 females) were studied during this study. Majority of patients were in the age group of 24–30 years. Fever was found in 42 cases (84%), left-upper-quadrant pain in 36 cases (72%), mass per abdomen in 29 cases (58%), and rashes in 1 case (2%). These were the main clinical signs. Laboratory tests revealed leukocytosis and elevated levels of C-reactive protein (CRP) in all cases. All patients were investigated further with ultrasound and computed tomography (CT) scan. The primary focus of infection included infective endocarditis, pneumonia, pelvic abscess, retroviral disease, skin infection, and enteric fever. There was one case of epithelial cyst of the spleen that was secondarily infected and in eight cases, the etiology was not found. Treatment included surgical intervention (total splenectomy and percutaneous drainage) and conservative management with antibiotics or a combination. Both were successful. The outcome was generally favorable with the exception of two cases who succumbed to death due to septic shock. Conclusion: Abscess in the spleen is a rare condition. The clinical expression is highly polymorphic. A positive diagnosis is based on correlation of clinical features, laboratory values, and imaging. Early diagnosis with prompt suspicion is necessary to ensure timely treatment and favorable outcome.

Keywords

• abscess
• antibiotics
• percutaneous drainage
• spleen
• splenectomy