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February 1989, Vol 149, No. 2 >
ARTICLE | February 1989

Computed Tomography in the Diagnosis of Splenic Emboli-Reply

JACOB I. HAFT, MD
Arch Intern Med. 1989;149(2):471. doi:10.1001/archinte.1989.00390020151040.
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In Reply.—We would like to thank Ho and Marsepoil for their interest in our article, and for affording us an opportunity to clarify the message of our article. Ho and Marsepoil agree with our conclusion that our data suggest that finding splenic involvement on computed tomographic (CT) scan can serve to support the diagnosis of bacterial endocarditis. They then assert that in patients with an established diagnosis of bacterial endocarditis, a CT scan can only be useful to diagnose splenic infarction or massive abscess. The point of our article was that abdominal CT may document subtle emboli to the spleen and may thereby help in establishing that a valve with bacterial vegetations has been a source for emboli and that valvular surgery (not splenectomy) may be indicated. The point that Ho and Marsepoil make with regard to ultrasound is of interest, but there are no data on the value

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