Aseptic Abscess Syndrome (AAS)

 

The patient has:

(1) fever

(2) abdominal pain

(3) leukocytosis

(4) focal collections of neutrophils (abscesses) within one or more organs, most often intra-abdominal

(5) negative bacterial and fungal cultures

 

The abscesses may be in:

(1) spleen

(2) lymph nodes

(3) pancreas

(4) liver

(5) lung

(6) brain

 

The patient does not respond to antibiotics but does respond to corticosteroids with or without TNF-alpha blockade.

 

Conditions associated with AAS:

(1) inflammatory bowel disease (Crohn’s disease, ulcerative colitis)

(2) relapsing polychondritis

(3) idiopathic

 

Related disorder: pustular form of pyoderma gangrenosum

 

Differential diagnosis:

(1) abscess with failure to culture the underlying organism (error in collection, handling or culturing)