Home Melange Aseptic Abscess syndrome: Autoimmune diseases in 2022 Immediate medical response bails out!

Aseptic Abscess syndrome: Autoimmune diseases in 2022 Immediate medical response bails out!

by Prittle Prattle Team

Doctors at Kamineni Hospitals treat a young woman suffering from Aseptic abscess syndrome

Aseptic Abscess syndrome is an autoinflammatory disease with fever, abdominal pain, and abscesses usually involving the spleen, liver; and associated with Inflammatory Bowel Disease in the majority of the cases. Cutaneous lesions are present only in 20% of the cases and are mainly cutaneous abscesses. It is often a relapsing condition and the CT scan may be an appropriate diagnostic tool in the setting of recurrent episodes of fever and pain in the abdomen. Lab tests like ESR, CRP are often elevated with elevated white blood count in the basic blood pictures.

A 21-year-old woman Lakshmi (Name changed) from Khammam was suffering from a unique autoimmune disease, Aseptic abscess syndrome with pyoderma gangrenosum which has gone undiagnosed for a long time. She was given intensive antibiotic therapy but no response and advised removal of spleen in the hospitals where she visited earlier. She was then referred to Kamineni Hospitals, LB Nagar.

Doctors at Kamineni Hospitals had successfully treated this rare disease, Aseptic abscess syndrome with pyoderma gangrenosum. She was not given a solid diagnosis or treatment elsewhere for high fever, nodules, and multiple ulcers over both hands and legs of sudden onset. On ultrasonography, multiple abscesses in the spleen were noted.

“We had examined the patient’s condition with her complete medical history and did an ultrasound abdomen, skin biopsy, and basic blood tests. The patient had been diagnosed with a rare condition that affects the skin and internal organs severely called aseptic abscess syndrome with pyoderma gangrenosum. We have given her steroid injections under strict monitoring and liquidated her with immunomodulator tablets. Within 2 months, Abscesses in the spleen resolved but the cutaneous ulcers were resistant to tablets. Hence, we had started biological injections (newer therapies) sequentially under strict supervision with follow-ups, which helped with the overactive immune system that was acting against her and patient got back to her normal health status” said Dr. Ramadevi B, Consultant Dermatologist, Kamineni Hospitals, LB Nagar.

They were about to remove her spleen but we are extremely happy to salvage it, the puzzle as to why this young girl deteriorated all of a sudden was solved. We are beyond happy to develop an abundance of trust with this patient and her family” Dr. Ramadevi B, Consultant Dermatologist, Kamineni Hospitals added further.

Aseptic abscess syndrome is a kind of autoinflammatory illness that was first identified in 1995. It appears as circular, sterile abscesses made mostly of neutrophils, affecting the liver, abdominal lymph nodes, lungs, skin, and, most notably, the spleen. The symptoms include fever, high erythrocyte sedimentation rate, and raised C-reactive protein; nevertheless, antibiotic treatment is ineffective. It has a great reaction to steroids. Aseptic abscess syndrome necessitates an immediate diagnosis and a differential diagnosis. We present a case of numerous abscesses of the spleen, liver, and skin that were treated with steroids and colchicine.
A 43-year-old male patient complained of fever, exhaustion, weight loss, and several wounds with discharge on the extremities. His history includes stomach discomfort, nausea, and exhaustion that began four years earlier, and magnetic resonance imaging revealed an abscess in the liver. The patient was monitored for cancer and was treated symptomatically. He experienced significant stomach pain about a month ago, and several splenic abscesses were discovered; so, he underwent a splenectomy. He developed abscesses on the distal regions of his upper and lower limbs, with purulent discharge that expanded fast 2 weeks after splenectomy; hence, he received ceftriaxone for 14 days but did not improve from the medication.
On arrival, a dermatologic examination indicated that the patient’s distal upper and lower limbs had a number of subcutaneous nodules, with each leg having 6–7 nodules, particularly around the wrists and ankles. These nodules gradually deepened to create abscesses, and the dehiscence of the abscesses resulted in well-circumscribed necrotic ulcers with disconnected borders. The ulcers advanced to the tendon over time, and there were lesions at various stages that developed in the same way.

This article was shared to Prittle Prattle News as a Press Release.

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