Year :
2016
| Month :
October
| Volume :
10
| Issue :
10
| Page :
OC22 - OC25
Full Version
Experience with Splenic Abscess from Southern India
Published: October 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/22108.8628
Mallikarjuna Shetty, Swaroopa Deme, KNKJ Mohan, Krishna Prasad Adiraju, Nageswar Rao Modugu, Naval Chandra, AMVR Narendra, Sathyanarayana raju Yadati
1. Associate Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
2. Assistant Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
3. Resident, Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
4. Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
5. Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
6. Additional Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
7. Additional Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
8. Professor & Head, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.
Correspondence Address :
Dr. Mallikarjuna Shetty,
Associate Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences,
Punjagutta, Hyderabad – 500082, Telangana, India.
E-mail: nimsshetty@yahoo.com
Abstract
Introduction: Splenic abscess is a rare entity with potentially life threatening complications. Sparse recent published data are available documenting the aetiological profile and management of patients with splenic abscess from India.
Aim: To study the clinical profile of splenic abscess.
Materials and Methods: We retrospectively collected data from case records of admitted patients with splenic abscesses, to Nizam’s Institute of Medical Sciences and Hospital which is a multispecialty, tertiary care referral hospital over a period of 15 months (from March 2014 to May 2015) and parameters studied were age, sex, symptoms, signs, risk factors, investigations like Ultrasound, CT scan, blood & microbiological culture, treatment and outcome.
Results: Most common presenting symptom was fever (90%). Mean age was 33.5 years. Five patients (55%) had risk factors like HIV, leukaemia and diabetes. From pus culture Escherichia coli was the most common organism (22%) grown. Staphylococcus saureus, Enterococcus faecium were seen in one each, blood culture grown Cryptococcus neoformans, Pseudomonas aeroginosa in one each, Plasmodium falciparum was seen on peripheral smear in one. Three were empirically treated as disseminated koch’s. Another was treated as possible infective endocarditis. All were given antimicrobials, five (55%) were treated with antimicrobials alone, three (33%) with PCD (Per Cutaneous Drainage) and one (11%) with sub-total splenectomy. All patients recovered.
Conclusion: With early diagnosis and increased use of ultrasound guided procedures like aspiration or drainage, spleenectomy can be avoided. Optimal treatment for splenic abscess is yet to be defined and customized to each patient.
Keywords
Percutaneous drainage, Mortality, Spleenectomy
DOI: 10.7860/JCDR/2016/22108.8628
Date of Submission: Jun 16, 2016
Date of Peer Review: Jul 02, 2016
Date of Acceptance: Sep 03, 2016
Date of Publishing: Oct 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
|