A bilateral knee septic arthritis due to Salmonella enteritidis developed in a female patient affected by long-standing systemic lupus erythematosus (SLE) with cardiac and renal involvement treated with immunosuppressants and corticosteroids. Because avascular necrosis and multiple osteomyelitic areas were detected at the same time in both right and left femoral condyles, an early localisation of Salmonella into the bone was assumed. Involvement of the joints was regarded as consequence of local dissemination of infection. Ampicilline (0.2 g/kg body weight daily for 2 months) plus ciprofloxacin (1.5 g daily for 12 months) and withdrawal of immunosuppressants appeared to be effective in preventing complications of infection.

Hepatic splenosis represents the heterotopic implantation of splenic tissue caused by the spillage of cells from the spleen usually after splenectomy or splenic trauma. This condition is usually an incidental finding during surgery and its real incidence is unknown. Splenic implants, which can be placed anywhere in the abdominal cavity, are usually multiple and may be confused with different benign and malignant conditions such as renal tumors, abdominal lymphomas, and endometriosis. We hereby report an unusual case of multiple abdominal splenosis, with a particular intra-hepatic location, that could be misinterpreted as an hepato-cellular carcinoma.