MyMedR

Fulltext Ultrasound in the diagnosis of splenic abscess. Case report

Sivalingam S

Med J Malaysia, 1988 Dec;43(4):338-9.

PMID: 3071730

Matched MeSH terms: Splenic Diseases/diagnosis*

Fulltext A case of torsion of the spleen presenting as an acute abdomen

Wong SK, Renuka SN, Suppiah M

Med J Malaysia, 1994 Sep;49(3):295-6.

PMID: 7845284

A middle-aged man presented with acute abdomen was found to have torsion of the spleen on laparotomy with the spleen lying in an abnormal position. Wandering spleen is an unusual entity, with torsion being a common complication.

Matched MeSH terms: Splenic Diseases/diagnosis

Fulltext Detection of spleen abscesses facilitates diagnosis of melioidosis in Malaysian children

Mohan A, Manan K, Tan LS, Tan YC, Chin ST, Ahmad R, et al.

Int J Infect Dis, 2020 Sep;98:59-66.

PMID: 32535300 DOI: 10.1016/j.ijid.2020.06.025

OBJECTIVES: Melioidosis is associated with extremely high case fatality ratios. The aim of this study was to determine whether detection of abdominal visceral abscesses can facilitate diagnosis of melioidosis in children.

METHODS: We conducted a retrospective analysis of all children who had liver and/or spleen abscesses on abdominal ultrasonography admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2014 until December 2018.

RESULTS: Fifty-three children had liver and/or spleen abscesses. Spleen abscesses were present in 48 (91%) cases; liver abscesses in 15 (28%). Melioidosis was confirmed by culture in 9 (17%) children; small occult splenic abscesses were present in all cases. In 78% of these cases, the lesions were detected before any positive culture (or serology) results were available. Four (8%) children had bacteriologically-confirmed tuberculosis. Two (4%) had Staphylococcus aureus infection. Of the remaining 38 (72%) culture-negative cases, 36 (95%) had clinical and imaging characteristics similar to that of children with culture-confirmed melioidosis and improved with empirical melioidosis antibiotic therapy.

CONCLUSIONS: A large number of children in Bintulu Hospital in Sarawak, Malaysia, were found to have spleen abscesses. Melioidosis was the most common etiology identified in these children. Abdominal ultrasonography is extremely useful in facilitating the diagnosis of pediatric melioidosis.

Matched MeSH terms: Splenic Diseases/diagnosis*

Fulltext Honeycomb and necklace signs in liver abscesses secondary to melioidosis

Ong SCL, Alemam MMM, Zakaria NA, Abdul Halim NA

BMJ Case Rep, 2017 Oct 19;2017.

PMID: 29054959 DOI: 10.1136/bcr-2017-222342

Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions.

Matched MeSH terms: Splenic Diseases/diagnosis

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