Surgical Management of Splenic Abscess in Endocarditis

To the Editor.

—We read with interest the letter to the editor concerning splenic abscess in infectious endocarditis published in the FebruaryArchives.¹The authors reemphasized an important point: the frequency of splenic abscess is often underestimated in patients with infectious endocarditis. In the autopsy series of 78 patients described in this letter, the incidence of splenic abscess was 6.4%. Unfortunately, the authors did not indicate over what time period these 78 patients expired. In their series of 120 patients seen between 1974 and 1982, the incidence of splenic abscess was apparently only 0.8%. If we can combine these two series, the overall incidence is 3%, which is identical to what we quoted as a projection in our study.² We are concerned that the statement by the authors that "... splenectomy is rarely indicated... " may be misleading to readers. We would endeavor to reemphasize that although splenic abscesses