The sickling of red blood cells in sickle cell disease patients possesses the tendency of blocking the blood vessels that leads out of the spleen. Splenic or spleen abscess is relatively associated with bacteremia, particularly in the setting of abnormalities that are caused by trauma and hemoglobinopathy.
The diagnosis of splenic abscess in sickle cell disease patients is a clinical challenge but can be seen in the triad of fever (first and common presenting symptom of splenic abscess), the left upper quadrant tenderness and a possible leukocytosis (this usually occurs in one- third of the cases of splenic abscess), a confirmatory diagnosis of splenic abscess in patients would be done using a CT scan which is a computed tomography scan.
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Computed tomography (CT) scan is a useful diagnostic tool used in detecting diseases and injuries in patients. When a splenic abscess is misdiagnosed or not diagnosed at all in sickle cell disease patients, it becomes fatal, as it has reached a high mortality rate of seventy percent (70%) in approximation, and can be reduced to one percent (1%) with proper treatment.
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Splenic abscesses are most frequently seen as a complication of infected endocarditis in sickle cell disease patients, this occurs in approximately five percent (5%) of patients. Splenic abscess is known to occur from a contiguous focus of infection, it can also occur following an induced embolization via interventional radiology techniques to treat splenic artery pseudoaneurysm formation as a well-known complication of acute pancreatitis developed in sickle cell disease patients.
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Other medical conditions that cause the development of a splenic abscess in sickle cell disease patients also include neoplasms, metastatic infection, splenic infarction, and diabetes.
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Splenic abscess is commonly associated with pathogens such as; Streptococcus, Staphylococcus (this is present due to endocarditis, which is the major known cause of splenic abscess), Mycobacterium, fungi (usual candida), polymicrobial organisms in some cases, miscellaneous rare organisms like Burkholderia pseudomallei, and Actinomycetes, aerobes, anaerobes, and certain parasites.
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