Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, 22212, Republic of Korea.
Department of Internal Medicine, Seogwipo Medical Center, Jeju-do, Republic of Korea.
BMC Infect Dis. 2020 Dec 2;20(1):915. doi: 10.1186/s12879-020-05645-9.
The spleen contains immune cells and exhibits a pattern of infarction different from other organs; as such, splenic infarction (SI) may provide important clues to infection. However, the nature of the relationship between SI and infectious disease(s) is not well understood. Accordingly, this retrospective study investigated the relationship between SI and infection.
Hospital records of patients with SI, who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018, were reviewed. Patient data regarding clinical presentation, causative pathogens, risk factors, and radiological findings were collected and analyzed.
Of 353 patients with SI, 101 with infectious conditions were enrolled in this study, and their data were analyzed to identify associations between SI and infection. Ten patients were diagnosed with infective endocarditis (IE), and 26 exhibited bacteremia without IE. Twenty-seven patients experienced systemic infection due to miscellaneous causes (negative result on conventional automated blood culture), including the following intracellular organisms: parasites (malaria [n = 12], babesiosis [n = 1]); bacteria (scrub typhus [n = 5]); viruses (Epstein-Barr [n = 1], cytomegalovirus [n = 1]); and unidentified pathogen[s] (n = 7). Splenomegaly was more common among patients with miscellaneous systemic infection; infarction involving other organs was rare. Thirty-eight patients had localized infections (e.g., respiratory, intra-abdominal, or skin and soft tissue infection), and most (35 of 38) had other risk factors for SI.
In this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common causative pathogens. Further studies are needed to examine other possible etiologies and the underlying pathophysiological mechanisms.
脾脏含有免疫细胞，并表现出不同于其他器官的梗死模式；因此，脾梗死（SI）可能为感染提供重要线索。然而，SI 与传染病之间的关系性质尚不清楚。因此，本回顾性研究调查了 SI 与感染之间的关系。
回顾性分析 2008 年 1 月至 2018 年 12 月期间在韩国仁川仁荷大学医院就诊的 SI 患者的住院病历。收集并分析了患者的临床表现、病原体、危险因素和影像学表现等数据。
在 353 例 SI 患者中，纳入了 101 例有感染情况的患者进行本研究，并分析了 SI 与感染之间的关系。10 例患者被诊断为感染性心内膜炎（IE），26 例患者表现为无 IE 的菌血症。27 例患者因各种原因发生全身感染（常规自动血培养阴性），包括以下细胞内病原体：寄生虫（疟疾[n=12]，巴贝斯虫病[n=1]）；细菌（恙虫病[n=5]）；病毒（EB 病毒[n=1]，巨细胞病毒[n=1]）；和未鉴定病原体[n=7]。全身性感染的患者更常见脾肿大；其他器官梗死罕见。38 例患者有局部感染（如呼吸道、腹腔内或皮肤软组织感染），其中大多数（35/38）有其他 SI 的危险因素。
在本研究中，发现各种感染情况与 SI 相关，细胞内病原体是最常见的病原体。需要进一步研究以检查其他可能的病因和潜在的病理生理机制。
