Yousef Khan Fahmi, Elmudathir Ahmed, Abu Bakir Muhammed, Alsawaf Bisher
Department of Medicine, Hamad General Hospital, Doha, Qatar E-mail:
Qatar Med J. 2022 Mar 12;2022(1):16. doi: 10.5339/qmj.2022.16. eCollection 2022.
BACKGROUND & OBJECTIVES: Splenic abscess (SA) is a rare clinical entity. There is a lack of information on SA in most Arab and Gulf countries, including Qatar. This study describes the demographics, clinical features, microbiologic etiologies, treatments, and outcomes of patients with SA at the largest tertiary medical center in Qatar over the previous six years.
This retrospective observational study was conducted at Hamad general hospital. It involved all patients of 18 years old or above who were admitted with the diagnosis of SA for the period between January 1, 2015, and December 31, 2020.
We recruited 25 patients, of which 14 (56%) were males, and 11 (44%) were females. The mean age ( ± SD) of them was 48.64 ± 19.08 years. The mean illness duration was 22.88 ± 11.88 days. Fever was the most common presenting symptom and was found in 21 (84%) cases, whereas bacteremia was the most predisposing factor found in 15 (60%) patients. The etiology of SA was bacterial in 16 cases (64%), mixed (fungal and bacterial) in one (4%), and tuberculous in one (4%), whereas the etiological agent was unidentified in seven (28%) cases. Intravenous antimicrobial therapy was administered empirically in all patients. However, seven patients (28%) received intravenous antibiotics as the only treatment modality for SA, 15 patients (60%) underwent percutaneous drainage with a pigtail catheter, and two patients underwent splenectomy. The inhospital mortality was three (12%).
This study showed that SA could be caused by various organisms that should be isolated to guide the choice of antimicrobial agents. An abdominal computed tomography is a good diagnostic modality, whereas computed tomography- and ultrasonography-guided percutaneous drainage were efficient therapeutic options that reduce the need for surgery.
脾脓肿(SA)是一种罕见的临床病症。在包括卡塔尔在内的大多数阿拉伯和海湾国家,关于脾脓肿的信息匮乏。本研究描述了卡塔尔最大的三级医疗中心过去六年中脾脓肿患者的人口统计学特征、临床特征、微生物病因、治疗方法及治疗结果。
本回顾性观察性研究在哈马德总医院进行。研究对象为2015年1月1日至2020年12月31日期间因脾脓肿诊断入院的所有18岁及以上患者。
我们招募了25名患者,其中14名(56%)为男性,11名(44%)为女性。他们的平均年龄(±标准差)为48.64±19.08岁。平均病程为22.88±11.88天。发热是最常见的首发症状,在21例(84%)患者中出现,而菌血症是最主要的诱发因素,在15例(60%)患者中发现。脾脓肿的病因在16例(64%)中为细菌性,1例(4%)为混合性(真菌和细菌),1例(4%)为结核性,7例(28%)病因不明。所有患者均经验性给予静脉抗菌治疗。然而,7例(28%)患者仅接受静脉抗生素作为脾脓肿的唯一治疗方式,15例(60%)患者接受了经皮猪尾导管引流,2例患者接受了脾切除术。住院死亡率为3例(12%)。
本研究表明,脾脓肿可能由多种病原体引起,应进行分离以指导抗菌药物的选择。腹部计算机断层扫描是一种良好的诊断方法,而计算机断层扫描和超声引导下的经皮引流是有效的治疗选择,可减少手术需求。