Splenic Abscess

Definition

Splenic abscess is a rare but serious condition where a collection of pus forms within the spleen.

Types

• Simple splenic abscess: a single abscess without any complications
• Complex splenic abscess: multiple abscesses or abscesses with complications

Causes

• Infections (bacterial, fungal, or parasitic)
• Trauma to the spleen
• Immunocompromised states (e.g., HIV, cancer, or taking immunosuppressive medications)
• Splenic infarction or ischemia

Risk Factors

• Previous splenectomy or splenectomy with retained spleen
• Splenic artery thrombosis or embolism
• Hematologic disorders (e.g., sickle cell disease)
• Previous abdominal surgery

Pathophysiology

• Infection of the spleen by bacteria, fungi, or parasites
• Inflammation and necrosis of the splenic tissue
• Collection of pus within the spleen

Clinical Features

• Fever
• Left upper quadrant pain
• Systemic symptoms (e.g., chills, fatigue, weight loss)
• Abdominal tenderness and guarding
• Splenomegaly (enlargement of the spleen)

Pathology

• Microscopic:
  • Inflammation and necrosis of the splenic tissue
  • Presence of pus within the splenic sinusoids
  • Abscess formation
• Macroscopic:
  • Enlargement of the spleen
  • Presence of one or more abscesses
  • Splenic infarction or ischemia

Investigations

• Laboratory:
  • Complete blood count (CBC) with elevated white blood cell count
  • Blood cultures for bacteria, fungi, or parasites
  • Liver function tests (LFTs)
• Imaging:
  • Ultrasound (US) of the abdomen
  • Computed tomography (CT) scan of the abdomen
  • Magnetic resonance imaging (MRI) of the abdomen

Complications

• Rupture of the abscess
• Sepsis
• Fistula formation (e.g., splenorenal or splenic colon fistula)
• Splenic infarction or ischemia

Management

• Medical:
  • Antibiotics for bacterial infections
  • Antifungal medications for fungal infections
  • Antiparasitic medications for parasitic infections
  • Supportive care (e.g., fluids, nutrition)
• Surgical:
  • Splenectomy (removal of the spleen)
  • Drainage of the abscess
  • Repair of any associated injuries or complications

Treatment

• Medical:
  • Antibiotics for bacterial infections
  • Antifungal medications for fungal infections
  • Antiparasitic medications for parasitic infections
• Surgical:
  • Splenectomy (removal of the spleen)
  • Drainage of the abscess
  • Repair of any associated injuries or complications

Homoeopathic Therapeutic Medicines

• Arsenicum album: for bacterial infections
• Hepar sulphuris: for abscesses and fistulas
• Silica: for splenomegaly and splenitis
• Phosphorus: for splenic infarction and ischemia