Yoshikawa K, Tsukiyama F, Aisaka T
Department of Internal Medicine, Hiroshima City Funairi Hospital.
Kansenshogaku Zasshi. 1993 Apr;67(4):366-70. doi: 10.11150/kansenshogakuzasshi1970.67.366.
Solitary splenic abscess is a rare disease and usually treated with splenectomy. A 78-year-old female with diabetes mellitus and liver cirrhosis was admitted to our hospital in a state of fever and left hypochondralgia. The abdominal ultrasonogram and CT scan showed the splenomegaly and one abnormal mass in the spleen. Drainage under sonographic guidance was attempted to the splenic mass but only a little amount of aspiration fluid was obtained, from which Salmonella Enteritidis was detected. No other abscess in the other organs was detected, resulting in the diagnosis as solitary splenic abscess caused by S. Enteritidis. Antibiotic therapy was carried out and the abscess disappeared judging from the ultrasonogram, CT scan, and laboratory data. The present case suggests that the fully application of ultrasonogram, CT scan, and drainage for the diagnosis leads to the healing of solitary splenic abscess without operation. This is the first case of S. Enteritidis infection in the spleen reported in Japan.
孤立性脾脓肿是一种罕见疾病,通常采用脾切除术治疗。一名78岁患有糖尿病和肝硬化的女性因发热和左季肋部疼痛入住我院。腹部超声和CT扫描显示脾肿大,脾脏内有一个异常肿块。尝试在超声引导下对脾脏肿块进行引流,但仅获得少量抽吸液,从中检测出肠炎沙门氏菌。未在其他器官检测到其他脓肿,诊断为肠炎沙门氏菌引起的孤立性脾脓肿。进行了抗生素治疗,根据超声、CT扫描和实验室数据判断脓肿已消失。本病例表明,充分应用超声、CT扫描和引流进行诊断可使孤立性脾脓肿无需手术即可治愈。这是日本报道的首例脾脏肠炎沙门氏菌感染病例。