Al-Tawfiq Jaffar A
Internal Medicine Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran, Saudi Arabia.
Intern Med. 2008;47(1):69-72. doi: 10.2169/internalmedicine.47.0428. Epub 2008 Jan 1.
Splenic abscess is not an uncommon complication of patients with sickle-cell disease. Here we describe an 18 year-old boy with sickle cell disease and left upper quadrant abdominal pain. Computerized axial tomography revealed left sided free flowing pleural effusion and splenomegaly with liquefaction and possible gas formation. The splenic fluid grew an unusual organism known as Bacteroides distasonis. The patient received antimicrobial therapy and underwent a splenectomy with full recovery. The spleen was cystically infarcted and measured 22 x 16 x 5 cm. The capsule was thickened and covered by fibrinous exudate. Histopathologic examination of the spleen showed complete necrosis with reparative fibrosis. This case presents an unusual cause of splenic abscess due to Bacteroides distasonis with a subacute to chronic course. The presence of fever and left sided pleuritic chest pain in patients with sickle cell disease should raise the suspicion of splenic abscess.
脾脓肿是镰状细胞病患者并不少见的并发症。在此，我们描述一名18岁患有镰状细胞病且左上腹疼痛的男孩。计算机断层扫描显示左侧有自由流动的胸腔积液以及脾肿大伴液化且可能有气体形成。脾液培养出一种不常见的微生物，即狄氏拟杆菌。患者接受了抗菌治疗并接受了脾切除术，最终完全康复。脾脏呈囊性梗死，大小为22×16×5厘米。包膜增厚，被纤维蛋白渗出物覆盖。脾脏的组织病理学检查显示完全坏死并伴有修复性纤维化。该病例呈现了由狄氏拟杆菌引起的脾脓肿的不寻常病因，病程为亚急性至慢性。镰状细胞病患者出现发热和左侧胸膜炎性胸痛应引起对脾脓肿的怀疑。
