A patient presents with fever for 3 weeks. On examination he is observed to have splenomegaly. Ultrasonography reveals a hypoechoic shadow in spleen near the hilum. Gram-positive bacilli are isolated on blood culture. Which of the following is the most likely causative organism?
Splenic abscess- Rare condition- Healthy patient having unilocular abscess - moality rate is 15 -20%- Immunocompromised, multilocular - moality rate is 80%- Predisposing factors:* Malignancy* Polycythemia vera* IV drug abuse* HIV positive* Hemoglobinopathy* UTI- MC organism responsible - staph aureus- Other organisms responsible* Streptococcus* Salmonella* Gram negative enteric bacilli- Fungal abscess is typically seen in HIV positive and immunocompromised caused bycandidaClinical features- Abdominal pain- Tenderness- Peritonitis- Pruritic chest painInvestigation- Investigation of choice - CECTTreatment- Unilocular abscess - drainage + antibiotics- Multilocular abscess - splenectomy + drainage of left upper quadrant + antibiotics
Cytomegalovirus
Toxoplasmosis
Staphylococcal
Lymphoma virus
Spleen