Conservative management of isolated splenic abscess in children.
BACKGROUND
Isolated splenic abscesses (SAs) are rare in children. We report a single-center experience with emphasis on their diagnosis, etiology, treatment, and outcome.


METHODS
This is a retrospective review.


RESULTS
Eighteen children (age, 3-16 years; male-female ratio, 5:1) were managed over a period of 8 years in a tertiary-care institution. Presenting symptoms included fever, abdominal pain, and anorexia. Splenomegaly was present in 12 (67%), leukocytosis in 9 (50%), and thrombocytosis in 12 (67%) patients. Associated diseases were thalassemia (1), tuberculosis (1), and typhoid fever (9). Solitary and multiple SAs were seen in equal numbers. Blood culture grew Salmonella paratyphi A in 1 case. Splenic aspirate culture was positive in 3 (Escherichia coli [1], S paratyphi A [1], Acinetobacter [1]). Widal serology was positive in 9 (50%) patients. Management consisted of intravenous broad-spectrum antibiotic therapy in all patients, together with percutaneous aspiration in 10 (56%) cases where the abscess size was greater than 3 cm. All patients responded, and complete resolution was observed.


CONCLUSIONS
Isolated SA in children responds favorably to conservative treatment with intravenous broad-spectrum antibiotics and percutaneous drainage without the need for splenectomy.
Choudhury
Subhasis Roy
SR
Department of Pediatric Surgery, Lady Hardinge Medical, College and Kalawati Saran Children's Hospital, New Delhi 110001, India. roychouin@yahoo.co.in
Debnath
Pinaki Ranjan
PR
Jain
Prashant
P
Kushwaha
Anand Singh
AS
Puri
Archana
A
Chadha
Rajiv
R
Sonker
Pitamber
P
D000038:Abscess / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D004756:Enterobacteriaceae Infections / Q000628:therapy; D004927:Escherichia coli Infections / Q000628:therapy; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents