最初表现为肺炎伴胸腔积液的脾脓肿:2 岁女孩的罕见病例:病例报告

Siao-Rong Chen, Chuen-Bin Jiang
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摘要

脾脓肿很少在幼儿期被发现。虽然大多数病例通常表现为发烧、腹痛和呕吐,但其中一些病例可能会危及生命。本研究旨在探讨早期发现如何预防严重的疾病并发症。 一名持续发烧和呼吸急促的两岁儿童被收治入院。体格检查显示左侧呼吸音减弱。我们使用经验性抗生素并进行胸管引流 2 天,但没有效果。孩子没有退烧,左上腹痛持续存在。腹部超声波检查时意外发现左侧脾脏有巨大肿块。 巨大脾脓肿。 为了确诊,医生进行了高分辨率超声波检查和腹部计算机断层扫描。在计算机断层扫描引导下,顺利进行了经皮引流术,并使用了抗生素。治疗过程中未发现明显不良反应。治疗 10 天后,通过超声波观察到临床症状迅速改善,肿块缩小,发热消退。 经过 3 个月的随访,没有发现脓肿复发的迹象。 脾脓肿必须及早诊断和干预,以防止可能出现的不祥后果。本病例研究表明,计算机断层扫描引导下的经皮引流术,加上适当的抗生素治疗,可以显著改善单发单眼脾脓肿,即使脓肿较大也不例外。这种方法展示了有效处理脾脓肿的潜力,并避免了脾切除术等更具侵入性的手术。
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Splenic abscess presenting as pneumonia with pleural effusion initially: A rare case in a 2-year-old girl: A case report
Splenic abscess is rarely discovered during the toddler period. Although most of the cases are typically marked by fever, abdominal pain, and vomiting, some of them may suffer life-threatening situations. This study aimed to explore how early detection can prevent serious disease complications. A 2-year-old child with persisted fever and shortness of breathing was admitted. Physical examination was decreasing breathing sound on the left side. We gave empirical antibiotics use with chest tube drainage for 2 days in vain. No fever dropping and persistent left upper abdominal pain were noted. A huge mass was found on left spleen incidentally during abdominal ultrasound screen. Huge splenic abscess. High-resolution ultrasound and abdominal computer tomogram were conducted to confirm the diagnosis. Percutaneous drainage under computer tomography-guided with antibiotic use was smoothly. No obvious adverse effects were noted during the treatment course. Rapid clinical improvement with decreasing size was observed by ultrasound 10 days after the treatment and fever subsided. A period of 3-month follow-up revealed no evidence of recurrence of abscess. Early diagnosis and intervention are mandatory for splenic abscess to prevent possible ominous consequences. The case study has shown that computer tomography-guided percutaneous drainage, along with appropriate antibiotic therapy, can significantly impact solitary unilocular splenic abscesses, even if they are large. This approach demonstrates the potential to effectively manage splenic abscesses and avoid the need for more invasive procedures such as splenectomy.
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