Chulay J D, Lankerani M R
Am J Med. 1976 Oct;61(4):513-22. doi: 10.1016/0002-9343(76)90331-4.
Ten cases of splenic abscess seen between 1964 and 1974 are reviewed. Pain referable to the abscess was the most common symptom, but was present in only five cases. Fever was present in all but one case. Tenderness in the region of the spleen was noted in six cases, in three cases the spleen was palpable and in one case a large mass in the upper left quadrant of the abdomen was palpated. Abdominal films were suggestive of the diagnosis in two cases, and the liver-spleen scan demonstrated a defect in three cases. Seven abscesses were caused by gram-negative bacilli of bowel origin; the etiologic agents in the other three were Staphylococcus aureus, Streptobacillus moniliformis and a Nocardia species. Associated conditions predisposing to splenic abscess included trauma in three cases, splenic arteritis or embolization in five cases, and foci of infection elsewhere in the body in six, including two cases of endocarditis. The mortality was 60 per cent. Half of the deaths were due to the underlying illness, but failure to diagnose splenic abscess contributed to a fatal outcome in three cases.
回顾了1964年至1974年间所见的10例脾脓肿病例。与脓肿相关的疼痛是最常见的症状，但仅在5例中出现。除1例之外，所有病例均有发热。6例在脾区有压痛，3例可触及脾脏，1例在左上腹触及一巨大肿块。腹部X线片在2例中提示诊断，肝脾扫描在3例中显示有缺损。7例脓肿由肠道来源的革兰氏阴性杆菌引起；另外3例的病原体为金黄色葡萄球菌、念珠状链杆菌和诺卡氏菌属。易患脾脓肿的相关情况包括3例有外伤史，5例有脾动脉炎或脾动脉栓塞，6例有身体其他部位的感染灶，其中2例有感染性心内膜炎。死亡率为60%。半数死亡是由于基础疾病，但未能诊断出脾脓肿在3例中导致了致命后果。
