Abstract
We report a case of spontaneous splenic rupture (SSR) caused by a Bacillus species (sp.) infection. A 36-year-old man on warfarin therapy since an aortic valve replacement at the age of 13 was admitted to our hospital with a 3-week history of a high fever. He had been asymptomatic until 4 months previously, when he suffered a cerebral embolism despite adequate oral anticoagulation. Abdominal computed tomography revealed splenic infarctions, which resulted in splenic rupture 2 days later. After embolization of the splenic artery, splenectomy was successfully performed. Pathologic examination revealed splenic infarction, resulting from septic emboli, with associated rupture of the splenic capsule, but no abscess was found. Bacillus sp. was isolated from cultures of arterial blood preoperatively, and the excised splenic specimens, postoperatively. In addition to rupture of the suppurating intrasplenic vessels with hematoma formation, the anticoagulant therapy possibly contributed to distension of the intrasplenic hematoma.
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Kapan M, Kapan S, Karabicak I, Bavunogle I. Simultaneous rupture of the liver and spleen in a patient on warfarin therapy: report of a case. Surg Today 2005;35:252–255.
Chen E, Chen Z, Wu S, Wang X. Niemann-Pick disease resulting in spontaneous splenic rupture in an adult: report of a case. Surg Today 2008;38:473–475.
Sliman R, Rehm S, Shlaes DM. Serious infections caused by Bacillus species. Medicine 1987;66:218–223.
Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis. Diagnosis, antimicrobial therapy, and management of complications. A statement for healthcare professionals from the committee on rheumatic fever, endocarditis, and Kawasaki disease, council on cardiovascular disease in the young, and the councils on clinical cardiology, stroke, and cardiovascular surgery and anesthesia, American Heart Association. Circulation 2005;111:e394–433.
Tuazon CU, Murray HW, Levy C, Solny MN, Curtin JA, Sheagren JN. Serious infections from Bacillus sp. JAMA 1979;241:1137–1140.
Krause A, Gould FK, Forty J. Prosthetic heart valve endocarditis caused by Bacillus circulans. J Infect 1999;39:160–162.
Gatermann S, Mitusch R, Djonlagic H, Hollandt H, Marre R. Endocarditis caused by Bacillus circulans. Infection 1991;19:445.
Truninger K, Attenhofer Jost CH, Seifert B, Vogt PR, Follath F, Schaffner A, et al. Long-term follow-up of prosthetic valve endocarditis: what characteristics identify patients who were treated successfully with antibiotics alone? Heart 1999;82:714–720.
Dimitrakakis G, Von Oppell U, Zilidis G, Srivastava A. Splenic rupture complicating aortic valve replacement for bacterial endocarditis. Int Cardiovasc Thorac Surg 2008;7:138–140.
Llanwarne N, Badic B, Delugeau V, Landen S. Spontaneous splenic rupture associated with Listeria endocarditis. Am J Emerg Med 2007;25:1086.e 3–5.
Ting W, Silverman NA, Arzouman DA, Levitsky S. Splenic septic emboli in endocarditis. Circulation 1990;82(suppl IV):IV-105–IV-109.
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Aoyagi, S., Kosuga, T., Ogata, T. et al. Spontaneous rupture of the spleen caused by a Bacillus infection: Report of a case. Surg Today 39, 733–737 (2009). https://doi.org/10.1007/s00595-008-3911-7
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DOI: https://doi.org/10.1007/s00595-008-3911-7