To the Editor.—To further the study by Haft and coworkers1 concerning the opportunity of abdominal computed tomographic (CT) examinations in the management of bacterial endocarditis (BE), we would like to point out the need to distinguish two different situations.
When the diagnosis of BE is not quite established, the detection of splenic lesions or other metastatic localizations (liver, kidney, adrenal glands, and arteries) is contributory to this diagnosis. Several series from the literature have documented the frequency of such complications during BE2 and the reliability of CT scans in detecting them.3-6
Balthazar and Hilton4 even described radiologic signs correlated with anatomic findings, allowing the differentiation between splenic infarctions, abscesses, or subcapsular collections.
However, when the diagnosis of BE is certain, a CT scan can be usefully considered only for early diagnosis of splenic lesions requiring prompt surgical care (spontaneous rupture of the spleen or voluminous splenic