J Med Assoc Thai 2009; 92 (11):1476

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CT Findings of Liver and Splenic Abscesses in Melioidosis: Comparison with Those in Non-Melioidosis
Laopaiboon V Mail, Chamadol N , Buttham H , Sukeepaisarnjareon W

Objective: To compare the CT findings of liver and splenic abscesses in melioidosis (ML) with non-melioidosis
(NML).

Material and method: CT (computed tomography) images of 47 patients with liver and splenic abscesses were
retrospectively reviewed. The 28 patients with ML abscesses and 19 with NML abscesses were recruited into
the present study. The sizes, shapes, distributions, margins, enhancement patterns and internal architectures
of abscesses on CT images were evaluated and analyzed by Chi-square and Fisher exact tests.

Results: Seven and 6 ML patients had liver and splenic abscesses alone respectively, and 15 patients had
combined liver and splenic abscesses. All NML patients had only liver abscesses. For liver abscesses, there
were 3 ML and 13 NML patients with abscess size > 3 cm. Eleven ML and no NML patients had abscesses < 3
cm (p = 0.00). The abscesses were multiple and discretely distributed in all 11 ML patients, but none in NML
patients (p = 0.002). Seven ML and 13 NML patients had moderate to marked peripheral enhancement (95%
CI: - 0.7, -0.01). All splenic abscesses (21 patients) found that B. pseudomallei was the causative organism.
They were mostly smaller than 3 cm in size (85.71%), multiple (95.24%), and had no or minimal enhancement
(85.71%).

Conclusion: The CT findings of liver abscesses that can help to differentiate ML from NML include sizes,
distributions, and enhancement patterns. The features of ML splenic abscesses in the present study were small,
multiple, with no or minimal contrast enhancement.

Keywords:
Abscess, Liver abscess, Melioidosis, Splenic diseases, Tomography, X-ray computed

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