Watanapa P, Vathanophas V
J Med Assoc Thai. 1989 Sep;72(9):481-6.
Splenic abscess is an unusual disease and may be presented either as a localized area of infection in the spleen or as a part of generalized sepsis. Population-based autopsy studies have established the incidence of splenic abscess at between 0.2-0.7 per cent. An eleven-year retrospective study of cases of splenic abscess treated at Siriraj hospital, a total of 9 cases, is presented. Pseudomonas pseudomallei is the most frequent causative agent, found in one-third of the cases, especially if the patient is thalassemic or a resident in the Northeastern part of the country. Thalassemia is also the leading predisposing condition of this malady with the incidence of 33 per cent. There are some differences in the presenting clinical features in Thai patients compared with those reported in the literature. Splenectomy was performed in all but one who died of leukemia preoperatively. The mortality rate of this disease in this series is 11 per cent and we recommend splenectomy under antibiotic coverage as soon as the diagnosis of splenic abscess has been confirmed.
脾脓肿是一种罕见疾病，可表现为脾脏局部感染区域或作为全身性脓毒症的一部分。基于人群的尸检研究确定脾脓肿的发病率在0.2%至0.7%之间。本文介绍了对诗里拉吉医院治疗的脾脓肿病例进行的一项为期11年的回顾性研究，共9例。伪鼻疽伯克霍尔德菌是最常见的病原体，在三分之一的病例中发现，特别是如果患者是地中海贫血患者或该国东北部居民。地中海贫血也是这种疾病的主要易感因素，发病率为33%。泰国患者的临床表现与文献报道的有所不同。除1例术前死于白血病外，其余均行脾切除术。该系列中这种疾病的死亡率为11%，我们建议在确诊脾脓肿后尽快在抗生素覆盖下进行脾切除术。
