Splenic Infarction and Infectious Diseases in Korea

Abstract

Background Although the etiology of splenic infarction (SI) is multi-factorial, the nature of its relationship with infectious diseases is not well understood. We thus aimed to investigate the relationship between SI and infection using a retrospective approach. Methods We reviewed the hospital records of patients with SI who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018. We collected and analyzed data on the patients’ clinical presentation, causative pathogens, risk factors, and radiologic findings. Results Of the 353 patients with SI, 101 patients with infectious conditions were enrolled in the study and their data were analyzed to identify an association between SI and infection. Ten patients were diagnosed as having infective endocarditis (IE), and 26 patients had bacteremia without IE. Twenty-seven patients had systemic infection due to miscellaneous causes (negative result on conventional automatic blood culture), such as the following intracellular organisms: parasites (12 cases of malaria and 1 case of babesiosis), bacteria (five cases of scrub typhus), viruses (one case each of Epstein–Barr virus infection and cytomegalovirus infection) or not identified pathogen (seven cases). Splenomegaly was more common among patients with miscellaneous systemic infection, and infarction involving other organs was rare. Twenty-one patients had localized infections (e.g. respiratory, intra-abdominal, or skin and soft tissue infection), and most of them (18 of 21) had other risk factors of SI. Conclusions In this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common pathogens observed. Further studies are needed to examine other possible etiologies and the underlying pathophysiologic mechanisms.