目的:脾脓肿(SA)是一种罕见的临床实体。大多数阿拉伯和海湾国家缺乏关于南非的信息,包括卡塔尔。这项研究描述了人口统计,临床特征,微生物学病因,治疗,以及过去六年卡塔尔最大的三级医疗中心的SA患者的结局。
方法:这项回顾性观察研究在哈马德综合医院进行。它涉及2015年1月1日至2020年12月31日期间诊断为SA的所有18岁或以上患者。
结果:我们招募了25名患者,其中14人(56%)是男性,11名(44%)为女性。他们的平均年龄(±SD)为48.64±19.08岁。平均病程为22.88±11.88天。发热是最常见的症状,在21例(84%)中发现,而菌血症是15例(60%)患者中发现的最易感因素。16例(64%)SA的病因为细菌性,混合(真菌和细菌)在一个(4%),和结核性(4%),而7例(28%)病例的病因不明。所有患者均凭经验进行静脉抗菌治疗。然而,7名患者(28%)接受静脉注射抗生素作为SA的唯一治疗方式,15例(60%)患者接受了猪尾导管经皮引流,两名患者接受了脾切除术。住院死亡率为3例(12%)。
结论:这项研究表明,SA可能是由各种生物引起的,应将其分离以指导抗菌药物的选择。腹部计算机断层扫描是一种很好的诊断方式,而计算机断层摄影和超声引导经皮穿刺引流术是减少手术需要的有效治疗选择.
OBJECTIVE: Splenic abscess (SA) is a rare clinical entity. There is a lack of information on SA in most Arab and Gulf countries, including Qatar. This study describes the demographics, clinical features, microbiologic etiologies, treatments, and outcomes of patients with SA at the largest tertiary medical center in Qatar over the previous six years.
METHODS: This retrospective observational study was conducted at Hamad general hospital. It involved all patients of 18 years old or above who were admitted with the diagnosis of SA for the period between January 1, 2015, and December 31, 2020.
RESULTS: We recruited 25 patients, of which 14 (56%) were males, and 11 (44%) were females. The mean age ( ± SD) of them was 48.64 ± 19.08 years. The mean illness duration was 22.88 ± 11.88 days. Fever was the most common presenting symptom and was found in 21 (84%) cases, whereas bacteremia was the most predisposing factor found in 15 (60%) patients. The etiology of SA was bacterial in 16 cases (64%), mixed (fungal and bacterial) in one (4%), and tuberculous in one (4%), whereas the etiological agent was unidentified in seven (28%) cases. Intravenous antimicrobial therapy was administered empirically in all patients. However, seven patients (28%) received intravenous antibiotics as the only treatment modality for SA, 15 patients (60%) underwent percutaneous drainage with a pigtail catheter, and two patients underwent splenectomy. The inhospital mortality was three (12%).
CONCLUSIONS: This study showed that SA could be caused by various organisms that should be isolated to guide the choice of antimicrobial agents. An abdominal computed tomography is a good diagnostic modality, whereas computed tomography- and ultrasonography-guided percutaneous drainage were efficient therapeutic options that reduce the need for surgery.