Primary splenic abscess in an adult female patient: a case report

Abstract Background Primary splenic abscess is rare and typically presents in patients who are immunocompromised. We present a case of a 47-year-old apparently immunocompetent female patient who was diagnosed with primary splenic abscess from a Salmonella Typhimurium infection following emergency la...

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Main Authors: Burce Isik, Matthew G. Davey, Sarah Gaffney, Patrick J. Stapleton, Javier Mohigefer, Efthymios Koutroumanos
Format: Article
Language:English
Published: Japan Surgical Society 2024-03-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-024-01849-2
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author Burce Isik
Matthew G. Davey
Sarah Gaffney
Patrick J. Stapleton
Javier Mohigefer
Efthymios Koutroumanos
author_facet Burce Isik
Matthew G. Davey
Sarah Gaffney
Patrick J. Stapleton
Javier Mohigefer
Efthymios Koutroumanos
author_sort Burce Isik
collection DOAJ
description Abstract Background Primary splenic abscess is rare and typically presents in patients who are immunocompromised. We present a case of a 47-year-old apparently immunocompetent female patient who was diagnosed with primary splenic abscess from a Salmonella Typhimurium infection following emergency laparotomy. Case presentation A 47-year-old female patient presented with subjective fever and severe epigastric and left flank pain. She was treated empirically with intravenous piperacillin/tazobactam and gentamicin and was resuscitated with intravenous crystalloid infusion. A radiological diagnosis of splenic infarct secondary to splenic artery aneurysm superimposed with splenic abscess was presumed, however at emergency laparotomy, primary splenic abscess was identified. This abscess had eroded the left hemidiaphragm and had ruptured the splenic capsule leading to intra-abdominal pus in the pelvis which on culture grew Salmonella Typhimurium. A splenectomy and primary repair of the left hemidiaphragm were performed, with postoperative pancreatitis diagnosed following the procedure. After intensive care treatment, this patient made a full recovery. Conclusion This case of primary splenic abscess was treated successfully with a combination of surgery (i.e.: splenectomy and surgical drainage), prolonged antimicrobial therapy, and intensive care in the perioperative period.
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spelling doaj-art-6740a4077b2a4f7db7ea60306f2324862025-08-20T02:51:53ZengJapan Surgical SocietySurgical Case Reports2198-77932024-03-011011510.1186/s40792-024-01849-2Primary splenic abscess in an adult female patient: a case reportBurce Isik0Matthew G. Davey1Sarah Gaffney2Patrick J. Stapleton3Javier Mohigefer4Efthymios Koutroumanos5University of Limerick School of MedicineDepartment of Surgery, University Hospital LimerickDepartment of Anaesthesia and Intensive Care, University Hospital LimerickDepartment of Microbiology, University Hospital LimerickDepartment of Histopathology, University Hospital LimerickDepartment of Surgery, University Hospital LimerickAbstract Background Primary splenic abscess is rare and typically presents in patients who are immunocompromised. We present a case of a 47-year-old apparently immunocompetent female patient who was diagnosed with primary splenic abscess from a Salmonella Typhimurium infection following emergency laparotomy. Case presentation A 47-year-old female patient presented with subjective fever and severe epigastric and left flank pain. She was treated empirically with intravenous piperacillin/tazobactam and gentamicin and was resuscitated with intravenous crystalloid infusion. A radiological diagnosis of splenic infarct secondary to splenic artery aneurysm superimposed with splenic abscess was presumed, however at emergency laparotomy, primary splenic abscess was identified. This abscess had eroded the left hemidiaphragm and had ruptured the splenic capsule leading to intra-abdominal pus in the pelvis which on culture grew Salmonella Typhimurium. A splenectomy and primary repair of the left hemidiaphragm were performed, with postoperative pancreatitis diagnosed following the procedure. After intensive care treatment, this patient made a full recovery. Conclusion This case of primary splenic abscess was treated successfully with a combination of surgery (i.e.: splenectomy and surgical drainage), prolonged antimicrobial therapy, and intensive care in the perioperative period.https://doi.org/10.1186/s40792-024-01849-2Primary splenic abscessSplenic infarctLaparotomySplenectomyAcute abdomen
spellingShingle Burce Isik
Matthew G. Davey
Sarah Gaffney
Patrick J. Stapleton
Javier Mohigefer
Efthymios Koutroumanos
Primary splenic abscess in an adult female patient: a case report
Surgical Case Reports
Primary splenic abscess
Splenic infarct
Laparotomy
Splenectomy
Acute abdomen
title Primary splenic abscess in an adult female patient: a case report
title_full Primary splenic abscess in an adult female patient: a case report
title_fullStr Primary splenic abscess in an adult female patient: a case report
title_full_unstemmed Primary splenic abscess in an adult female patient: a case report
title_short Primary splenic abscess in an adult female patient: a case report
title_sort primary splenic abscess in an adult female patient a case report
topic Primary splenic abscess
Splenic infarct
Laparotomy
Splenectomy
Acute abdomen
url https://doi.org/10.1186/s40792-024-01849-2
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