Johns Hopkins ABX Guide
Splenic Abscess
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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Last updated: November 10, 2022
Citation
DeMarco, Carmen, and Christopher F Carpenter. "Splenic Abscess." Johns Hopkins ABX Guide, The Johns Hopkins University, 2022. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540514/all/Splenic_Abscess.
DeMarco C, Carpenter CF. Splenic Abscess. Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540514/all/Splenic_Abscess. Accessed October 31, 2025.
DeMarco, C., & Carpenter, C. F. (2022). Splenic Abscess. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540514/all/Splenic_Abscess
DeMarco C, Carpenter CF. Splenic Abscess [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2022. [cited 2025 October 31]. Available from: https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540514/all/Splenic_Abscess.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Splenic Abscess
ID - 540514
A1 - DeMarco,Carmen,M.D.
AU - Carpenter,Christopher,M.D.
Y1 - 2022/11/10/
BT - Johns Hopkins ABX Guide
UR - https://peds.unboundmedicine.com/pedscentral/view/Johns_Hopkins_ABX_Guide/540514/all/Splenic_Abscess
PB - The Johns Hopkins University
DB - Pediatrics Central
DP - Unbound Medicine
ER -
