AIM： To analyze 67 cases of splenic abscess in a medica center of Taiwan during a period of 19 years. METHODS： From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the re...AIM： To analyze 67 cases of splenic abscess in a medica center of Taiwan during a period of 19 years. METHODS： From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed. RESULTS： There were 41 males and 26 females with the mean age of 54.14-14.1 years. Multiple splenic abscesses （MSA） account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients （35.8%） had extrasplenic abscesses, with leading site of liver （34.6%）, Microbiological cultures were positive in 58 patients （86.6%）, with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus （GNB） infection predominated （55.2%）, with leading pathogen of Klebslella pneumoniae （22.4%）, followed by gram positive coccus （GPC） infection （31%）. Splenectomy was performed in 26 patients （38.8%）, percutaneous drainage or aspiration in 21 （31.3%）, and antibiotic therapy alone in 20 patients （29.9%）. Eventually, 12 of 67 patients expired （17.9 %）. By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC （P=0.036）. Patients with GNB infection （P=0.009） and multiple abscesses （P=0.011） experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 ex- pired patients （16.3±3.2） was significantly higher than that of the 55 survivals （7.2 ± 3.8） （P〈 0.001）. CONCLUSION： MSA, GNB infection, and high APACHE Ⅱ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.展开更多
文摘AIM： To analyze 67 cases of splenic abscess in a medica center of Taiwan during a period of 19 years. METHODS： From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed. RESULTS： There were 41 males and 26 females with the mean age of 54.14-14.1 years. Multiple splenic abscesses （MSA） account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients （35.8%） had extrasplenic abscesses, with leading site of liver （34.6%）, Microbiological cultures were positive in 58 patients （86.6%）, with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus （GNB） infection predominated （55.2%）, with leading pathogen of Klebslella pneumoniae （22.4%）, followed by gram positive coccus （GPC） infection （31%）. Splenectomy was performed in 26 patients （38.8%）, percutaneous drainage or aspiration in 21 （31.3%）, and antibiotic therapy alone in 20 patients （29.9%）. Eventually, 12 of 67 patients expired （17.9 %）. By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC （P=0.036）. Patients with GNB infection （P=0.009） and multiple abscesses （P=0.011） experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 ex- pired patients （16.3±3.2） was significantly higher than that of the 55 survivals （7.2 ± 3.8） （P〈 0.001）. CONCLUSION： MSA, GNB infection, and high APACHE Ⅱ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.
