Splenic abscess associated with active infective endocarditis

Yoshikai, Masaru; Kamachi, M.; Kobayashi, Keita; Murayama, Junichi; Kamohara, Keiji; Minematsu, Noritoshi

doi:10.1007/bf02919639

Cited by 21 publications

(16 citation statements)

References 6 publications

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“…Here, we present the findings of six reports published to date, on the outcome of patients in relation to the order of surgical therapies for IE complicated with SA [2,[6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 97%

Infective endocarditis complicated with splenic abscess successfully treated with splenectomy followed by double valve replacement

Naito

Mitani

Ishiwata

et al. 2010

Journal of Cardiology Cases

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Splenic abscess (SA) is a rare complication of infective endocarditis (IE). A successful outcome lies with a choice between medical and surgical treatments. However, there is still insufficient evidence in the decision-making process.Our patient was a 73-year-old male who complained mainly of fever and general fatigue. An echocardiography showed vegetation of 10 mm in diameter and severe mitral and aortic regurgitation and a diagnosis was made of IE. Because of a recent brain embolism, we decided to treat him initially with medical therapy. Antibiotics were effective, but on the 28th day after starting treatment, he complained of left upper abdominal pain. An abdominal computed tomography scan showed SA. The administration of vancomycin did not improve the condition. We decided that he should undergo surgical treatment.A splenectomy was performed and 9 days after the splenectomy, the mitral and aortic valves were successfully replaced.There is still no clear-cut evidence to support the order of surgical interventions. Indeed, the current guidelines, which recommend that splenectomy is to be performed first, are not supported by strong evidence. The present case report showed that splenectomy before valve surgery successfully treated the patient.

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“…Here, we present the findings of six reports published to date, on the outcome of patients in relation to the order of surgical therapies for IE complicated with SA [2,[6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 97%

Infective endocarditis complicated with splenic abscess successfully treated with splenectomy followed by double valve replacement

Naito

Mitani

Ishiwata

et al. 2010

Journal of Cardiology Cases

View full text Add to dashboard Cite

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“…However, impaired host defenses, metastatic pyogenic infection such as infective endocarditis, splenic trauma, hemoglobinopathy (sickle cell anemia), leukemia and immunodeficiency predisposes to splenic abscess. [2] Common etiologic agents of splenic abscess are staphylococci, streptococci, enterococcus and gramnegative bacteria e.g. Klebsiella, Escherichia coli and pseudomonas.…”

Section: Discussionmentioning

confidence: 99%

Multiple splenic abscesses in a child with enteric fever treated by percutaneous aspiration and antibiotics

Kanwal

Kaur

Kumar

2012

Ann Trop Med Public Health

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Multiple splenic abscesses are a condition associated with high mortality if there is delay in the diagnosis and initiation of specific treatment. Salmonella typhi as an etiological cause of multiple splenic abscesses is a distinct rarity. In the past treatment for splenic abscess including in enteric fever was splenectomy however; conservative treatment by percutaneous drainage is increasingly being reported for isolated splenic abscess and now for multiple splenic abscesses. We report a child with enteric fever who presented with multiple splenic abscesses and was successfully treated by percutaneous aspiration and antibiotics.

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“…Additional antibiotic should be administered empirically according to the risk index and quickly checked for effectiveness. In patients with splenic abscesses the IR helps to identify patients who need urgent splenectomy [16,17].…”

Section: Discussionmentioning

confidence: 99%

Difficulties in the treatment of infective endocarditis of unknown aetiology complicated by haemorrhagic stroke, cerebellum stroke, and spleen abscesses

Kraśnicka-Sokół¹,

Brodowski²,

Kanafa³

et al. 2016

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Słowa kluczowe: infekcyjne zapalenie wsierdzia, udar niedokrwienny mózgu, udar niedokrwienny móżdżku, ropnie śledziony. AbstractA 59-year-old man was admitted to the Rheumatology Department in order to conduct diagnostics of a hypoechogenic lesion located in the lower pole of the spleen. After 17 days of hospitalisation at the Department of Rheumatology and the Department of Neurology, the patient was referred to the Internal Medicine Ward due to a suspicion of advanced infective endocarditis. Seven days of antibiotic and antifungal therapy resulted in a reduction of C-reactive protein levels from 133.38 mg/l to 29.78 mg/l. Control echocardiography did not show progression of bacterial vegetation, but revealed an increase in the severity of bicuspid valve regurgitation. Following pharmacotherapy, on the 23 rd day of hospitalisation the patient was transferred to the Department of Cardiosurgery and Transplantology at the Institute of Cardiology for urgent surgical treatment. After successful surgery the patient underwent physiotherapy, resulting in partial resolution of neurological symptoms. Currently, 2 years after the event, the patient remains in good general state. We therefore conclude that the IE Risk Index is of high clinical value. StreszczenieMężczyzna 59-letni został przyjęty do Kliniki Reumatologii w celu rozpoznania zmiany hipoechogennej w obrębie dolnego bieguna śledziony. Ze względu na podejrzenie infekcyjnego zapalenia wsierdzia po 17 dniach leczenia w Klinice Reumatologii oraz Klinice Neurologii został przeniesiony na Oddział Chorób Wewnętrznych. Po 7 dniach farmakoterapii antybiotykami oraz lekiem przciwgrzybiczym nastąpiło zmniejszenie stężenia białka C-reaktywnego z maksymalnej wartości 133,38 mg/l do 29,78 mg/l. Echokardiograficznie nie stwierdzono progresji wegetacji, natomiast zwiększyła się niedomykalność zastawki dwudzielnej. Z tego powodu chory w 23. dobie hospitalizacji został skierowany ze wskazań życiowych na pilną operację do Kliniki Kardiochirurgii. Operacja przebiegła bez powikłań. Po 2-letnim okresie rehabilitacji częściowo ustąpiły porażenia i zaburzenia równowagi związane z udarami. Obecnie chory jest w stanie dobrym.

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Splenic abscess associated with active infective endocarditis

Cited by 21 publications

References 6 publications

Infective endocarditis complicated with splenic abscess successfully treated with splenectomy followed by double valve replacement

Infective endocarditis complicated with splenic abscess successfully treated with splenectomy followed by double valve replacement

Multiple splenic abscesses in a child with enteric fever treated by percutaneous aspiration and antibiotics

Difficulties in the treatment of infective endocarditis of unknown aetiology complicated by haemorrhagic stroke, cerebellum stroke, and spleen abscesses

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