A Case of Splenic Abscess Complicated by Infective Endocarditis

Abstract

Background: Splenic abscess is a rare but well-documented complication of infective endocarditis. We report a case of splenic abscess associated with infective endocarditis with evidence of sepsis, vegetation, and positive blood cultures. Case Presentation: A 92-year-old female presented to our department with a high-grade fever and disturbance of consciousness. Laboratory data revealed leukocytosis and an elevation of C-reactive protein. Computed tomography and ultrasonography revealed a cystic mass at the lower lobe of the spleen that measured 5 cm in diameter. On the basis of images and laboratory data of leukocytosis, a diagnosis of septic shock associated with splenic abscess was made. Antibiotics and splenectomy alleviated the patient's inflammatory reactions and improved her septic shock. Blood culture at arrival was positive for Escherichia coli. Transesophageal echocardiography was performed, revealing an 8-mm vegetation at the anterior leaflet of the mitral valve without any evidence of congestive heart failure. Administration of cefmetazole 2 g/d was continued for 28 days until the patient's inflammatory reactions improved and the vegetation disappeared. Conclusion: Physicians should always be aware of potential infective endocarditis whenever splenic abscess is encountered.