Lee Chen-Hsiang, Leu Hsieh-Shong, Hu Tsung-Hui, Liu Jien-Wei
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Feb;37(1):39-44.
The clinical characteristics and isolated pathogens from 49 cases of splenic abscess treated at a medical center in southern Taiwan between 1981 and 2001 were retrospectively analyzed. Male patients were predominant (63%). Mean age at presentation was 55 years (range, 19 to 78 years). The most common presentations were fever (95.9%, 47/49), abdominal pain confined to the left upper quadrant (67.3%, 33/49), left pleural effusion (55.1%, 27/49) and splenomegaly (55.1%, 27/49). Leukocytosis occurred in 39 patients (79.6%), and leucopenia in 3 (6.1%). Blood cultures were positive in 32 patients (65.3%). The most common pathogen was Klebsiella pneumoniae (16.3%, 8/54), a well-known Gram-negative bacillus causing liver abscess in Taiwan, followed by Escherichia coli and Salmonella spp. (each 11.1%, 6/54). Multiple splenic abscesses occurred predominantly in patients with underlying malignancies. Due to the rarity of splenic abscess and the increasing number of immunocompromised patients, multicenter study is needed to determine the epidemiological features and optimal management of this disease.
对1981年至2001年间在台湾南部一家医疗中心接受治疗的49例脾脓肿患者的临床特征及分离出的病原体进行了回顾性分析。男性患者居多（63%）。就诊时的平均年龄为55岁（范围19至78岁）。最常见的表现为发热（95.9%，47/49）、局限于左上腹的腹痛（67.3%，33/49）、左侧胸腔积液（55.1%，27/49）和脾肿大（55.1%，27/49）。39例患者出现白细胞增多（79.6%），3例出现白细胞减少（6.1%）。32例患者血培养呈阳性（65.3%）。最常见的病原体是肺炎克雷伯菌（16.3%，8/54），这是一种在台湾导致肝脓肿的著名革兰氏阴性杆菌，其次是大肠杆菌和沙门氏菌属（各占11.1%，6/54）。多发性脾脓肿主要发生在有潜在恶性肿瘤的患者中。由于脾脓肿罕见且免疫功能低下患者数量不断增加，需要进行多中心研究以确定该疾病的流行病学特征和最佳治疗方法。
