Jpn. J. Infect. Dis., 59 (5), 320-322, 2006
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Short Communication
A Case of Splenic Abscess during Treatment of Interstitial Pneumonia
Koichi Izumikawa1,2*, Yoshitomo Morinaga1, Kinichi Izumikawa1, Kohei Hara1 and Shigeru Kohno2
1Department of Internal Medicine, Izumikawa Hospital, Nagasaki 859-1504, and 2Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan
(Received May 15, 2006. Accepted June 19, 2006)
*Corresponding author: Mailing address: Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. Tel: +81-95-849-7273, Fax: +81-95-849-7285, E-mail: koizumik@nagasaki-u.ac.jp
SUMMARY: We experienced a case of a 76-year-old man who developed a splenic abscess while undergoing treatment for interstitial pneumonia. Splenic abscess-like abnormal intensities were accidentally found by the chest computed-tomography (CT) examinations 3 weeks after the initiation of corticosteroids and immunosuppressive treatment for interstitial pneumonia. An ultrasonography-guided percutaneous aspiration test resulted in the isolation of methicillin-resistant Staphylococcus aureus (MRSA). Since colonized MRSA had been detected intermittently from sputum after admission and the patient risked bloodstream infection from an indwelling central venous catheter and intubation, we suspected that the organism colonized in the airway had spread into the bloodstream via these devices. Although CT-guided percutaneous drainage followed by postoperative antibiotic therapy are normally required for the treatment of splenic abscess, the patient was successfully treated by the administration of vancomycin without drainage.