Jørgensen Anne Sofie Steinbring, Arsic Ivan, Pedersen Niels, Kristensen Lena Hagelskjær, Nielsen Michael F, Balslev Thomas
Department of Paediatrics, Viborg Regional Hospital, Viborg, Denmark.
Department of Radiology, Viborg Regional Hospital, Viborg, Denmark.
Case Rep Pediatr. 2023 Mar 13;2023:8802760. doi: 10.1155/2023/8802760. eCollection 2023.
Splenic abscesses are rare and potentially fatal. Diagnosis is often delayed due to vague symptoms, and laboratory findings are varying and often nonspecific. Ultrasound and computed tomography have a high sensitivity in detecting splenic abscesses. Splenectomy was previously considered the gold standard for treatment, but in recent years, a shift has been seen towards a more conservative approach, i.e., ultrasound-guided aspiration or drainage in combination with adequate antibiotics in selected cases. . A previously healthy adolescent complained of left-sided chest pain, pain in the left clavicular region for three weeks, and recent fever. Ultrasound and computed tomography demonstrated an intrasplenic abscess. The patient was successfully treated with two percutaneous fine-needle punctures and adequate antibiotics for six weeks. serotype Poona was grown from the aspirate. At one-year follow-up, the patient remained healthy without signs of recurrence.
The present case report demonstrates that ultrasound-guided aspiration and subsequent treatment with antibiotics may be an effective alternative to splenectomy in patients with a splenic abscess.
脾脓肿罕见且可能致命。由于症状不明确，诊断常常延迟，实验室检查结果各异且往往缺乏特异性。超声和计算机断层扫描在检测脾脓肿方面具有较高的敏感性。脾切除术曾被认为是治疗的金标准，但近年来，治疗方法已转向更为保守的方式，即在特定病例中采用超声引导下穿刺抽吸或引流并联合使用足量抗生素。一名既往健康的青少年主诉左侧胸痛、左锁骨区域疼痛三周，近期伴有发热。超声和计算机断层扫描显示脾内有脓肿。该患者通过两次经皮细针穿刺及六周的足量抗生素治疗获得成功治愈。从抽吸物中培养出波纳血清型。在一年的随访中，患者保持健康，无复发迹象。
本病例报告表明，对于脾脓肿患者，超声引导下穿刺抽吸并随后使用抗生素治疗可能是脾切除术的一种有效替代方法。
