Splenic Abscess

Carmen DeMarco, M.D., Christopher F. Carpenter, M.D.

PATHOGENS

PATHOGENS

PATHOGENS

  • Polymicrobial in up to 25%, including anaerobes.
    • Given that most splenic abscesses are secondary to bacteremia or fungemia (e.g., associated with endocarditis, UTI, pancreatitis, GI tract, etc.), the likely pathogen(s) are determined by the original focus.
  • Gram-negative bacilli, especially E. coli, Salmonella spp, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Serratia marcescens
  • Gram-positive bacteria: Staphylococcus aureus, Streptococci, Enterococci
  • Anaerobes: Peptostreptococci and microaerophilic streptococci, Clostridium spp, Fusobacterium spp, Bacteroides spp, Prevotella spp, Cutibacterium spp (ex Propionibacterium)
  • Candida spp.
    • Neutropenia and chronic corticosteroid use predispose to candidal splenic abscesses.
    • Chronic disseminated candidiasis (formerly hepatosplenic candidiasis) often includes frank candidal splenic abscesses.
  • Mycobacteria
    • Tuberculosis
  • Rare:
    • Burkholderia pseudomallei, Brucella spp, Bartonella, Coxiella burnetii, Actinomycetes,Plasmodium vivax
    • Aseptic abscesses have been described in association with Behçet’s disease.

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