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Computed tomography characteristics of hepatic and splenic abscesses associated with melioidosis: A 7‐year study
Author(s) -
Apisarnthanarak Piyaporn,
Thairatana Atita,
Muangsomboon Kobkun,
Lu David SK,
Mundy Linda M,
Apisarnthanarak Anucha
Publication year - 2011
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2011.02248.x
Subject(s) - medicine , melioidosis , odds ratio , spleen , confidence interval , hepatic abscess , gastroenterology , splenic disease , computed tomography , abscess , radiology , pathology , surgery , splenectomy
Purpose: This study aimed to characterise the CT findings associated with hepatic and splenic melioid abscesses. Methods: 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. Results: 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). Conclusion: The CT necklace sign, along with concurrent hepatic and splenic IAA, were highly suggestive of melioidosis in persons from Central Thailand.