Fungal splenic abscess

Abstract

Nineteen patients with fungal splenic abscesses included 16 with leukemia, 1 drug user, 1 patient with Cushing''s syndrome and 1 without predisposing causes. Fifteen had persistent fever; 6 had esophageal or mucocutaneous candidiasis. Abdominal pain occurred in 7 patients, splenomegaly occurred in 6 and left abdominal mass occurred in 1. Three chest X-ray films showed left pleural effusions; 2 had elevated left hemidiaphragms, 2 had left-sided infiltrates and 1 was normal. Sixteen of 17 99mTc S colloid scans were abnormal, as were 15 gallium citrate 67Ga scans. Two computed tomographic studies revealed splenic defects. Candida was the cause in 15 cases, Aspergillus was the cause in 3 cases, and Blastomyces dermatitidis was the cause in 1 case. Sixteen patients underwent splenectomy, 12 receiving postoperative antifungal therapy. Fifteen survived regardless of underlying disease or hepatic microabscesses.