Ishida T, Matsumura Y, Miyake A, Wazawa H, Tamada J
Department of Internal Medicine, Kurashiki Central Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Apr;29(4):482-6.
A 51-year-old female was admitted with high grade fever, cyanosis and hypoxemia. The chest X-ray showed nodular shadows on bilateral lung fields. Beta-streptococci were found on culture from the blood, and the fever fell after administration of both antibiotics and corticosteroid. Pulmonary angiography revealed four arteriovenous fistulae on bilateral lung fields. On abdominal ultrasonography and CT scan, a hypoechoic lesion with an irregular wall and varying internal echogenicity was detected within the spleen. This lesion changed in size and shape during the clinical course and diminished with improvement in the patient's condition. These findings were compatible with splenic abscess. Splenic abscess with pulmonary arteriovenous fistulae is rare.
一名51岁女性因高热、发绀和低氧血症入院。胸部X线显示双侧肺野有结节状阴影。血液培养发现β-链球菌，使用抗生素和皮质类固醇后体温下降。肺血管造影显示双侧肺野有四处动静脉瘘。腹部超声和CT扫描发现脾脏内有一个壁不规则、内部回声多样的低回声病变。该病变在病程中大小和形状发生变化，随着患者病情改善而缩小。这些发现符合脾脓肿。脾脓肿合并肺动静脉瘘较为罕见。
