Hepatic and Splenic Abscesses in Three Patients with Acute Leukemia

Abstract

Multiple low-density areas of the liver and spleen were detected by computed tomography in three febrile patients with acute myeloblastic leukemia. Diagnosis of hepatic and splenic abscesses was established by laparoscopy and/or splenectomy. Results of cultures of aspirated materials from the abscesses were helpful for selecting appropriate antimicrobial drugs in two patients while negative cultures were obtained in the remaining patient in whom antifungal drugs were effective. Prolonged administration of antimicrobial drugs was required for the cure or improvement of the complicating infections although all of the three patients remained in hematological remission.
Computed tomography of the abdomen should be made in all instances of unexplained fever during the course of acute leukemia. This practice will prove that hepatic and splenic abscesses, previously thought rare, actually occur in many patients with acute leukemia. The accurate diagnosis and immediate start of a potent antimicrobial treatment can improve the prognosis of these grave complications in compromised hosts.