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.
Department of Pediatric Surgery, Lady Hardinge Medical, College and Kalawati Saran Children's Hospital, New Delhi 110001, India. roychouin@yahoo.co.in
Subhasis Roy
SR
Choudhury
Pinaki Ranjan
PR
Debnath
Prashant
P
Jain
Anand Singh
AS
Kushwaha
Archana
A
Puri
Rajiv
R
Chadha
Pitamber
P
Sonker
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