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      Febre crônica associada a abscesso esplênico causado por Staphylococcus epidermidis Translated title: Chronic fever associated with splenic abscess due to Staphylococcus epidermidis

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          Abstract

          Abscessos ocultos são causa freqüente de febre crônica. Os abscessos esplênicos são entidades raras, usualmente associadas a quadros subjacentes de cirurgia abdominal, endocardite ou imunodepressão. Apresenta-se um caso de paciente com febre prolongada causada por um abscesso esplênico, cujo principal diagnóstico diferencial era leishmaniose visceral, que provavelmente esteve associado a traumatismo abdominal. O tratamento consistiu em antibioticoterapia seguida de esplenectomia.

          Translated abstract

          Occult abscesses are frequent causes of chronic fever. Splenic abscesses are rare entities that are usually associated with underlying conditions such as abdominal surgery, endocarditis or immunodepression. We report on the case of a patient with prolonged fever caused by a splenic abscess, whose main differential diagnosis was visceral leishmaniasis. However, this condition was probably related to abdominal trauma. The treatment consisted of antibiotics followed by splenectomy.

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          Most cited references18

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          MR imaging of the spleen: spectrum of abnormalities

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            Intra-abdominal abscess after blunt abdominal trauma.

            The relationship between blunt abdominal trauma and intra-abdominal abscess (IAA) is discussed infrequently; therefore we conducted a retrospective review of 4050 multiple blunt trauma admissions from January 1986 to July 1988. Of 325 patients who had a laparotomy for blunt abdominal trauma, we identified 15 (4.6%) who had 40 IAAs. The most common intra-abdominal injuries involved the spleen and liver. Splenectomy increased the risk for IAA in contrast to splenic salvage. Blunt injuries to the kidney and pancreas, when occurring in multiple trauma patients, carried a significant risk of IAA. Associated multiple extra-abdominal injuries and high transfusion requirements increased the risk for IAA formation. Most of the IAAs were located in the upper quadrants. There was a 46% incidence of multiple IAA, which in turn had an 80% chance of recurrence after initial drainage. Enterobacter species played an important role in the formation of IAA in our trauma patients. Three patients (20%) died. Poor prognostic indicators included a high injury severity score, high transfusion requirements, the presence of pelvic fracture, positive blood cultures, multiple organisms per abscess, and multiple-organ system failure.
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              Detection of circulating Leishmania chagasi DNA for the non-invasive diagnosis of human infection

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rsbmt
                Revista da Sociedade Brasileira de Medicina Tropical
                Rev. Soc. Bras. Med. Trop.
                Sociedade Brasileira de Medicina Tropical - SBMT (Uberaba )
                1678-9849
                October 2007
                : 40
                : 5
                : 588-590
                Affiliations
                [1 ] Universidade de Brasília Brazil
                [2 ] Universidade de Brasília Brazil
                Article
                S0037-86822007000500019
                10.1590/S0037-86822007000500019
                0b106a29-3438-49ea-8b0a-ecefd5ba9201

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0037-8682&lng=en
                Categories
                TROPICAL MEDICINE

                Infectious disease & Microbiology
                Splenic abscess,Staphylococcus epidermidis,Abdominal trauma,Abscesso esplênico,Febre prolongada,Traumatismo abdominal,Prolonged fever

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