The role of the spleen in resistance to infection.
WebMD examines the possible causes of an enlarged spleen, symptoms infections, such as endocarditis (an infection of your heart's valves). The spleen is a fist-sized organ found in the upper left side of your abdomen, next to an increased risk of infection, from a reduced number of white blood cells. Annu Rev Med. ; The role of the spleen in resistance to infection. Bohnsack JF, Brown EJ. The spleen serves two major critical functions in.
The Spleen. | Infectious Diseases | JAMA | JAMA Network
They are usually associated with another condition, including bacterial endocarditis, bacteremia, infection in an adjacent structure such as the peritoneum, immunocompromise, or splenic abnormalities. What pathogens are responsible for this disease? Bacterial Streptococci, especially those causing endocarditis, also group A Streptococcus Staphylococci, especially Staphylococcus aureus Salmonellae, Pseudomonas, Escherichia coli, Enterococcus spp.
The proportion of splenic abscesses due to mycobacteria has increased in recent series. Fungal Fungi are present in 7. The most common fungi are Candida. How do these pathogens cause splenic abscess?
Almost all splenic abscesses develop as a result of bacteremia or fungemia. A small percentage spread to the spleen from a contiguous site.
Endocarditis is the most classic underlying condition that results in splenic abscess. Urinary tract infection, surgical wound infections, and gastrointestinal infections that result in bacteremia can also lead to splenic abscess.
What other clinical manifestations may help me to diagnose and manage splenic abscess?
History Fever and other systemic symptoms are often the only symptoms of splenic abscess. Pain in the left upper quadrant, sometimes pleuritic in nature, and sometimes referred to the left shoulder may also be seen. Early satiety is another symptom that is noted occasionally. Physical exam There are often no physical findings other than fever and systemic signs of infection. Left-sided chest findings such as dullness, rales, or a rub at the base may be present. Less frequent signs include costovertebral angle tenderness, ascites, and hepatomegaly.
Enlarged spleen (splenomegaly) - Symptoms and causes - Mayo Clinic
A splenic rub may rarely occur. How can splenic abscess be prevented?Symptoms of an Enlarged Spleen
There are no prophylactic drugs that can be used and vaccines are not available. There are no published consensus guidelines for the treatment of splenic abscess. There are no prospective controlled trials of therapy for splenic abscess. All recommendations are based on published case series and expert opinion.
Series demonstrating ability to perform abscess drainage under magnetic resonance guidance and the relative usefulness of magnetic resonance for subphrenic locations. Textbook chapter reviewing splenic abscess.
Vaccines Persons who do not have a functioning spleen or have undergone a splenectomy should be given a pneumococcal polysaccharide vaccine a vaccine that prevents a bacterial infection of the lungs and other organsa meningococcal polysaccharide vaccine a vaccine that prevents a bacterial infection of the brain lining and other organsand a Haemophilus influenzaetype b vaccine a vaccine that prevents a bacterial infection of the brain lining, ear, and other organs.
After a splenectomy, discuss with your doctor when you should be vaccinated.
Also, keep a record of when you received these and other vaccines. Antibiotics Antibiotics medications that fight bacteria are needed daily to help prevent bacterial infections in infants and children without a functioning spleen.
Adults usually do not need daily antibiotics. However, if someone without a functioning spleen develops a fever, antibiotics may be needed. In addition, persons without a functioning spleen are susceptible to certain serious infections from dog bites or scratches and deer tick bites.
Seek medical care if you develop a fever or other illness and have impaired spleen function or have undergone splenectomy. Discuss with your doctor the need for antibiotic prescriptions for home and for travel. Also, you should wear a medical alert bracelet stating you do not have a spleen.