Table 1 Focused review of published cases of splenic abscess in bacterial infective endocarditis
Study | Number of patients | Management | Outcome |
|---|---|---|---|
Conservative management (medical therapy only) | |||
Jolobe OMP et al., 1983 [22] | 1 | Antibiotics | 8 week CT follow-up, complete resolution of splenic abscess |
Wang CC et al., 2009 [9] | 1 | Antibiotics | No mention of valve intervention 1 year follow-up, no complications |
Park S et al., 2009 [24] | 1 | Medical Therapy only | No recurrence |
Alnasser SA et al., 2019 [6] | 1 | Antibiotics Emergency valve replacement | 8 week follow-up CT showed smaller splenic abscess 1 year CT showed complete resolution 3 year follow-up no recurrence. |
Nallarajah J et al., 2020 [25] | 1 | Antibiotics | Prolonged hospital stay No relapse at 2 years |
Percutaneous drainage, no splenectomy | |||
McOwat L et al., 2015 [19] | 1 | Antibiotics Percutaneous drainage. | Unsuitable for splenectomy due to comorbidities No valve intervention. Biochemical marker improvement before discharge. |
Ulloa N et al., 2020 [10] | 1 | Antibiotics Percutaneous drainage Valve replacement | Discharged without complications |
Saijo F et al., 2022 [8] | 1 | Antibiotics Percutaneous drainage Valve replacement | 13 month follow-up, no complications |
Tsurui T et al., 2022 [21] | 1 | Antibiotics Percutaneous drainage | No information on valvular interventions 4 month follow-up CT showed splenic abscess reduction in size. |
Required surgical intervention on the spleen | |||
Yoshikai M et al., 2002 (case 1) [16] | 1/2 | Antibiotics Emergent valve replacement Open splenectomy same surgical time. | 4 year follow up No complications |
Yoshikai M et al., 2002 (case 2) [16] | 2/2 | Antibiotics Valve replacement Open splenectomy same surgical time | 1 year follow up No complications |
Yilmaz MB et al., 2003 [26] | 1 | Antibiotics Laparoscopic splenectomy Valve replacement | No postoperative complications |
Simsir SA et al., 2003 [20] | 1/2 | Antibiotics Laparoscopic splenectomy Valve replacement | 1 year + 9 months follow-up, no complications. |
Simsir SA et al., 2003 [20] | 2/2 | Antibiotics Percutaneous drainage Laparoscopic splenectomy Valve replacement | 2 years + 4 months follow-up. No complications. |
McCready RA et al., 2007 [27] | 1 | Antibiotics Valve replacement Open splenectomy (Same surgical time) | 17 month follow-up without recurrent infection |
Naito R et al., 2010 [17] | 1 | Antibiotics Open splenectomy Valve replacement | 6 month follow-up, no complictions |
Elasfar A et al., 2015 (case 1) [13] | 1/3 | Antibiotics Splenectomy Valve replacement | 9 month follow-up, no complications |
Elasfar A et al., 2015 (case 2) [13] | 2/3 | Antibiotics Valve replacement Emergency open splenectomy | 8 month follow-up, no complications |
Elasfar A et al., 2015 (case 3) [13] | 3/3 | Antibiotics Splenectomy Valve replacement | 5 week follow-up, no complications |
Blasi S et al., 2016 [11] (case 1) | 1/3 | Antibiotics Percutaneous drainage Laparoscopic splenectomy Valve replacement | 2 year + 9 month asymptomatic |
Blasi S et al., 2016 [11] (case 2) | 2/3 | Antibiotics Laparoscopic splenectomy Valve replacement | 8 month asymptomatic |
Blasi S et al., 2016 (case 3) [11] | 3/3 | Antibiotics Open splenectomy Valve replacement (Same time) | 1 month asymptomatic |
Aalaei-Andabili SH et al., 2017 [15] | 33 (17 splenic only + 16 splenic and CNS embolism) | 11 splenectomies 5 before cardiac surgery 4 concomitant 2 after. 22 antibiotics + CT follow-up | 8,7% overall mortality Higher AKI in splenectomy group. No additional interventions required after discharge for medical therapy only group. |
Lindsey ME et al., 2017 [28] | 1 | Antibiotics Percutaneous drainage Emergent Valve replacement Robotic assisted splenectomy. | Splenectomy performed 12 weeks after IV treatment due to persistent splenic collection to prevent re-infection. 2 year follow up no complications. |
Groga-Bada P et al., 2018 [18] | 1 | Antibiotics Splenectomy | No valve intervention No information on follow-up. |