Infective endocarditis with multiple splenic abscesses: a case report

• Published in: Nihon Kyukyu Igakukai Zasshi Vol. 20; no. 11; pp. 901 - 909
• Main Authors: Iwamura, Takashi, Higuchi, Kengo, Hirahara, Kenji, Samejima, Ryuichiro, Yunotani, Seiji, Nii, Takanobu, Yamasaki, Fumio
• Format: Journal Article
• Language: Japanese
• Published: Japanese Association for Acute Medicine 15.11.2009
• Subjects: culture-negative infective endocarditis; diabetes mellitus; magnetic resonance imaging; nosocomial infective endocarditis; splenectomy
• ISSN: 0915-924X; 1883-3772
• DOI: 10.3893/jjaam.20.901

The complication of a splenic abscess in infective endocarditis has been reported to occur in from 0.8 to 4.8% and this occurrence is rare. We herein report a case of multiple splenic abscesses complicating infective endocarditis. A 53-year-old female was admitted to our hospital due to a thalamic hemorrhage that was incurred in a traffic accident. On day 11, she felt significant left hypochondrial pain which appeared to be due to a splenic infarction. Subsequently, she suffered from hyper pyrexia for a few consecutive days. As a result of further examinations, she was diagnosed to have multiple splenic abscesses accompanied by infective endocarditis. Antibiotic treatment was initiated, but the low grade fever and inflammatory reaction were prolonged, and therefore we performed a splenectomy on day 48. Thereafter, the low grade fever was alleviated, and the inflammatory reaction subsided, thus resulting in a transfer to another hospital on day 99. We recommend that a splenectomy be performed at the early stage, if antibiotic therapy is not effective for the treatment of multiple splenic abscesses accompanied by infective endocarditis. In addition, if surgery is necessary for infective endocarditis, then it is important to perform a splenectomy for such patients.