Evaluation of characteristics associated with acute splenitis (septic spleen) as markers of systemic infection.

CONTEXT

Acute splenitis, also known as acute splenic tumor or septic spleen, is loosely defined as a neutrophilic infiltrate and congestion within the red pulp accompanied by splenomegaly. Standard pathology texts state that the histologic finding of acute splenitis is reflective of septic states. However, this association has seldom been tested in the medical literature.

OBJECTIVE

The purpose of this study was to determine if sepsis can be predicted by the presence of quantitative characteristics used to identify acute splenitis.

METHODS

The postmortem splenic tissue of 20 clinically diagnosed cases of sepsis and 20 noninfectious control cases were retrospectively examined in a blinded fashion for amount of neutrophilic infiltration, weight (obtained from autopsy report), and presence of congestion.

RESULTS

No significant correlation could be found between the parameters of neutrophilic infiltrate or splenic weight and clinically diagnosed septicemia. The presence of splenic congestion was unexpectedly found to be more likely with noninfectious causes of death.

CONCLUSION

Acute splenitis is presently ill defined, and no available evidence convincingly shows that its presence suggests a septic state.