Splenic abscess in southern Taiwan.

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.