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. 2015 Jul;27(3):210-5.
doi: 10.1016/j.jsha.2015.02.001. Epub 2015 Feb 14.

Splenic abscess associated with infective endocarditis; Case series

Abdelfatah Elasfar  1 , Abdulaziz AlBaradai  2 , Ziyad AlHarfi  2 , Mohamed Alassal  3 , Ayman Ghoneim  4 , Fahad AlGhofaili  2
Affiliations

Splenic abscess associated with infective endocarditis; Case series

Abdelfatah Elasfar et al. J Saudi Heart Assoc. 2015 Jul.

Abstract

Splenic abscess is a well-described but rare complication of infective endocarditis. Rapid diagnosis and treatment are essential as its course can be fatal. We present three case reports that describe the management of splenic abscesses in patients initially diagnosed with infective endocarditis. In all cases, the diagnosis was based on the findings of abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI). In two of the cases, splenectomy was performed before valve surgery; while in the third case, the spleen was removed after cardiac surgery. All three patients recovered fully, with satisfactory follow-up as outpatients. Immediate splenectomy, combined with appropriate antibiotics and valve replacement surgery alongside multi-disciplinary team work could be the treatment of choice in this clinical scenario.

Keywords: Infective endocarditis; Splenic abscess.

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Figures

Figure 1
Figure 1
(A) Case 1: Ultrasound abdomen showing partially defined anechoic avascular cystic lesion in the spleen, measuring 3.2 × 2.4 cm, likely representing a splenic abscess. (B) Case 1: Computed tomography (CT) scan of the abdomen showing enlarged spleen with large splenic lesion, likely representing an abscess.
Figure 2
Figure 2
(A) Case 2: Transthoracic echocardiography (TTE) view showing flail anterior mitral leaflet. (B) Case 2: TEE showing flail anterior mitral leaflet with large mobile mass attached to it, most likely representing vegetation.
Figure 3
Figure 3
(A) Case 3: CT scan of the abdomen showing large splenic abscess collection. (B) Case 3: CT scan of the brain showing (arrow) a small, faint hypodense area that could be related to the embolic phenomena of infective endocarditis (IE).
See this image and copyright information in PMC

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