Shetty Mallikarjuna, Deme Swaroopa, Mohan Knkj, Adiraju Krishna Prasad, Modugu Nageswar Rao, Chandra Naval, Narendra Amvr, Yadati Sathyanarayana Raju
Associate Professor, Department of General Medicine, Nizam's Institute of Medical Sciences , Hyderabad, Telangana, India .
Assistant Professor, Department of General Medicine, Nizam's Institute of Medical Sciences , Hyderabad, Telangana, India .
J Clin Diagn Res. 2016 Oct;10(10):OC22-OC25. doi: 10.7860/JCDR/2016/22108.8628. Epub 2016 Oct 1.
Splenic abscess is a rare entity with potentially life threatening complications. Sparse recent published data are available documenting the aetiological profile and management of patients with splenic abscess from India.
To study the clinical profile of splenic abscess.
We retrospectively collected data from case records of admitted patients with splenic abscesses, to Nizam's Institute of Medical Sciences and Hospital which is a multispecialty, tertiary care referral hospital over a period of 15 months (from March 2014 to May 2015) and parameters studied were age, sex, symptoms, signs, risk factors, investigations like Ultrasound, CT scan, blood & microbiological culture, treatment and outcome.
Most common presenting symptom was fever (90%). Mean age was 33.5 years. Five patients (55%) had risk factors like HIV, leukaemia and diabetes. From pus culture was the most common organism (22%) grown. , were seen in one each, blood culture grown , in one each, was seen on peripheral smear in one. Three were empirically treated as disseminated koch's. Another was treated as possible infective endocarditis. All were given antimicrobials, five (55%) were treated with antimicrobials alone, three (33%) with PCD (Per Cutaneous Drainage) and one (11%) with sub-total splenectomy. All patients recovered.
With early diagnosis and increased use of ultrasound guided procedures like aspiration or drainage, spleenectomy can be avoided. Optimal treatment for splenic abscess is yet to be defined and customized to each patient.
脾脓肿是一种罕见疾病，可引发危及生命的并发症。近期来自印度的已发表数据稀少，缺乏关于脾脓肿患者病因及治疗的记录。
研究脾脓肿的临床特征。
我们回顾性收集了在 Nizam 医学科学研究所和医院收治的脾脓肿患者的病例记录数据，该医院是一家多专科的三级转诊医院，研究时间段为 15 个月（从 2014 年 3 月至 2015 年 5 月），研究参数包括年龄、性别、症状、体征、危险因素、超声、CT 扫描、血液及微生物培养等检查、治疗及预后情况。
最常见的症状是发热（90%）。平均年龄为 33.5 岁。5 名患者（55%）有诸如 HIV、白血病和糖尿病等危险因素。脓液培养中最常见的培养出的微生物是[具体微生物名称未给出]（22%）。[其他具体微生物名称未给出]各有 1 例在脓液培养中出现，[具体微生物名称未给出]各有 1 例在血培养中生长，1 例在周边涂片上发现[具体微生物名称未给出]。3 例经验性地按播散性结核治疗。另 1 例按可能的感染性心内膜炎治疗。所有患者均给予抗菌药物，5 例（55%）仅接受抗菌药物治疗，3 例（33%）接受经皮引流（PCD），1 例（11%）接受脾次全切除术。所有患者均康复。
通过早期诊断以及增加使用超声引导下的穿刺或引流等操作，可以避免脾切除术。脾脓肿的最佳治疗方法尚未明确，需针对每位患者进行定制。
