Splenic abscess in cancer patients: a retrospective review

ABSTRACT

The objective of the study was to review our experience in the management of splenic abscess in cancer patients at a cancer hospital in Pakistan. This study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore and data reviewed from January 2007 till December 2012. Demographic, pathologic, radiologic and treatment records of each cancer patient with splenic abscess were retrieved from the electronic database. Patients were followed for a period of six months. Twelve patients were diagnosed with splenic abscess in the last six years. Males were ten compared to two female patients. Mean age was 41.1 years [range 3-64]. All except one were adults. Six patients had hematological malignancies while six were diagnosed with solid organ tumors, among the solid organ tumors three had metastatic disease with unknown primary. Six patients had multiple splenic abscesses while six patients had solitary abscesses. Bacterial cultures were positive in four patients, Pseudomonas species and Escherichia coli in two patients each; one patient with mycobacteria tuberculosis; no fungal growth identified in any patient. Antibiotics were given to all patients except one patient who died before any therapy due to end stage hepatocellular carcinoma. Three patients were treated with antituberculous therapy, two of them recovered while one was lost to follow-up. Percutaneous aspiration/drainage [PCD] was done in five patients; Surgery was performed in three patients. One patient who underwent PCD died due to septicemia while one patient died of cardiac event, two patients were lost to follow up while eight patients recovered completely. Percutaneous aspiration/drainage is an equally good option for treating splenic abscess as compared to surgery along with adequate antibiotics