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Original ArticleOpen Access
Splenic Abscess : Clinical Features, Microbiologic Finding, Treatment and Outcome
Sangchan A 
,
Mootsikapun P ,
Mairiang P
,
Mootsikapun P ,
Mairiang P APICHAT SANGCHAN, MD*
PIROON MOOTSIKAPUN, MD*
PISALN MAIRIANG, MD*
Splenic abscess is a rare clinical entity but may be underreported. A retrospective study at
Srinagarind Hospital revealed 60 cases of splenic abscess between 1992 and 2001. The causative
organisms were identified in 41 cases (68.3%). Gram negative bacilli were commonly isolated and
Burkholderia pseudomallei
was the most predominant. Diabetes mellitus and leukemia were common
underlying diseases found in 46.3 per cent and 9.7 per cent of culture confirmed cases, respectively. The
patients usually presented with fever, left upper quadrant pain, tenderness and splenomegaly. Multiple
abscesses were more commonly found in the melioidosis than in the non-melioidosis group (p
=
0.032),
but a single abscess was more commonly found in the non-melioidosis than in the melioidosis group
(p
=
0.032). Concurrent liver abscesses, often multiple, were not different in both groups. Antimicro-
bials alone were given in 66.7 per cent of cases with melioidosis and 64.7 per cent of non-melioidosis
group. Splenectomy and percutaneous aspiration were performed only in 29.3 per cent and 4.9 per cent
of cases with splenic abscess. The overall mortality rate of splenic abscess was only 4.9 per cent in the
present series.
In conclusion, splenic abscess is not uncommon.
Burkholderia pseudomalleli
is the most
common causative agent found in the present series. Therefore, it should be targeted in the initial empiri-
cal antibiotic therapy before the culture results are available especially when multiple lesions in the
spleen and concurrent multiple liver abscesses are seen. Prolonged treatment with appropriate anti-
microbials alone is usually effective. Splenectomy and/or aspiration may be useful in selected patients.
Key word : Splenic Abscess, Melioidosis,
Burkholderia Pseudomallei
PIROON MOOTSIKAPUN, MD*
PISALN MAIRIANG, MD*
Splenic abscess is a rare clinical entity but may be underreported. A retrospective study at
Srinagarind Hospital revealed 60 cases of splenic abscess between 1992 and 2001. The causative
organisms were identified in 41 cases (68.3%). Gram negative bacilli were commonly isolated and
Burkholderia pseudomallei
was the most predominant. Diabetes mellitus and leukemia were common
underlying diseases found in 46.3 per cent and 9.7 per cent of culture confirmed cases, respectively. The
patients usually presented with fever, left upper quadrant pain, tenderness and splenomegaly. Multiple
abscesses were more commonly found in the melioidosis than in the non-melioidosis group (p
=
0.032),
but a single abscess was more commonly found in the non-melioidosis than in the melioidosis group
(p
=
0.032). Concurrent liver abscesses, often multiple, were not different in both groups. Antimicro-
bials alone were given in 66.7 per cent of cases with melioidosis and 64.7 per cent of non-melioidosis
group. Splenectomy and percutaneous aspiration were performed only in 29.3 per cent and 4.9 per cent
of cases with splenic abscess. The overall mortality rate of splenic abscess was only 4.9 per cent in the
present series.
In conclusion, splenic abscess is not uncommon.
Burkholderia pseudomalleli
is the most
common causative agent found in the present series. Therefore, it should be targeted in the initial empiri-
cal antibiotic therapy before the culture results are available especially when multiple lesions in the
spleen and concurrent multiple liver abscesses are seen. Prolonged treatment with appropriate anti-
microbials alone is usually effective. Splenectomy and/or aspiration may be useful in selected patients.
Key word : Splenic Abscess, Melioidosis,
Burkholderia Pseudomallei
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