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- Title
Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: A 7-year study.
- Authors
Apisarnthanarak, Piyaporn; Thairatananon, Atita; Muangsomboon, Kobkun; Lu, David S. K.; Mundy, Linda M.; Apisarnthanarak, Anucha
- Abstract
This study aimed to characterise the CT findings associated with hepatic and splenic melioid abscesses. Patients with CT evidence of hepatic and/or splenic abscesses were retrospectively evaluated for clinical evidence of melioidosis over a 7-year period. After blinded review of the CT characteristics of intra-abdominal abscesses (IAA), we conducted a stratified analysis of patients with and without melioid IAA. Among 49 patients with CT evidence of hepatic and/or splenic IAA, the mean age was 50.2 years, 22 (44.9%) were women and eight (16.3%) had laboratory confirmation of melioidosis. For the 113 IAA, 33 were melioid abscesses (15 liver and 18 spleen) and 80 were non-melioid abscesses (69 liver and 11 spleen). Splenic IAA were more common in the melioid group ( P = 0.001) and smaller in diameter than the hepatic IAA ( P < 0.001). Melioid IAA were smaller than non-melioid IAA ( P < 0.001) and the CT necklace sign was the strongest predictor for melioid IAA (odds ratio = 24.6, P = 0.006) with 100% specificity. Other significant predictors for melioidosis were concurrent hepatic and splenic involvement ( P = 0.009), multiple abscesses ( P = 0.015) and residence in an endemic area ( P = 0.047). By multivariate analysis, concurrent hepatic and splenic involvement was the sole predictor of melioidosis (adjusted odds ratio = 11.3, 95% confidence interval = 1.6-77.5, P = 0.014). The CT necklace sign, along with concurrent hepatic and splenic IAA, were highly suggestive of melioidosis in persons from Central Thailand.
- Subjects
CASE studies; TOMOGRAPHY; ABSCESS treatment; HEPATIC manifestations of general diseases; SPLENIC artery
- Publication
Journal of Medical Imaging & Radiation Oncology, 2011, Vol 55, Issue 2, p176
- ISSN
1754-9477
- Publication type
Article
- DOI
10.1111/j.1754-9485.2011.02248.x