Feng-Lin Song1, Lin-Xin Lu, Cai-Xia Li, Xue-Zhong Yu, Yi Li. 1. Emergency Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Abstract
OBJECTIVE: To analyze the clinical manifestations, diagnosis, treatment and prognosis of patients with splenic abscess. METHOD: The clinical data, including baseline clinical data, clinical features, past history, pathogen culture result, treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital. RESULTS: The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days. Among them, 9 patients were cured, 8 were improved and 2 died. Risk factors, such as tumor burden, diabetes, and using immunosuppressive agents etc, can be found in most patients with splenic abscess. All the 19 patients had splenic image changes and non-specific clinical features. The most common three clinical symptoms were fever (18 cases), chills (12 cases) and shivering (11 cases). The most common three signs were abdominal tenderness (9 cases), left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases). The most common etiological culture results were gram negative bacilli (9 cases), gram positive coccus (8 cases), and fungi (4 cases). CONCLUSIONS: Clinical features are non-specific in splenic abscess patients. Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis. Empiric antibiotic administration should begin right after the diagnosis based on the image. Pathogen culture should be timely conducted after pus collection. Individual therapeutical protocol should be chosen according to patient's condition.
OBJECTIVE: To analyze the clinical manifestations, diagnosis, treatment and prognosis of patients with splenic abscess. METHOD: The clinical data, including baseline clinical data, clinical features, past history, pathogen culture result, treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital. RESULTS: The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days. Among them, 9 patients were cured, 8 were improved and 2 died. Risk factors, such as tumor burden, diabetes, and using immunosuppressive agents etc, can be found in most patients with splenic abscess. All the 19 patients had splenic image changes and non-specific clinical features. The most common three clinical symptoms were fever (18 cases), chills (12 cases) and shivering (11 cases). The most common three signs were abdominal tenderness (9 cases), left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases). The most common etiological culture results were gram negative bacilli (9 cases), gram positive coccus (8 cases), and fungi (4 cases). CONCLUSIONS: Clinical features are non-specific in splenic abscess patients. Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis. Empiric antibiotic administration should begin right after the diagnosis based on the image. Pathogen culture should be timely conducted after pus collection. Individual therapeutical protocol should be chosen according to patient's condition.