A Case of Splenic Abscess Diagnosed by Computed Tomography

Abstract

A 71-year-old man became febrile with transient pain of left upper quadrant for one or two days and admitted to prior hospital. He was treated with various antibiotics during about two months in prior hospital, but his fever continued and small amount of left pleural effusions were occasionally observed at his chest X-ray film. He was removed to Suibarago Hospital on July 17, 1980 introduced by prior hospital. On admission his temperature was 38.7°C, abdominal pain and jaundice were not present, liver, spleen and kidneys were not palpable. The WBC count was 19800/mm³ with 76% neutrophils and CRP reaction was 6+. No abnormality was found in his hepatic- and renal-function. Blood cultures were negative.
A computed tomography (CT) of upper abdominal region showed irregular shaped multiple (maximum size: 2.5×3.5 cm in diameter) low density areas in enlarged spleen at the left upper side of left kindney. The diagnosis of multiple spleenic abscess was made and chemotherapy was instituted with clindamycin, dibekacin and cefotetan. Clinical symptomes were not changed and CT findings after three weeks were stationary. Splenectomy was performed on August 21. The spleen was covered with adherent surroundings organs namely stomach, diaphragm, colon and omentum. Abscesses were present in various sized yellowish granulomatous lesions. Aerobic and anaerobic culture of purulent materials yielded no growth. The patient recovered and discharged on November 9.
CT is a non-invasive and valuable technique in diagnosis of spletiic abscess.