A Splenic Abscess which was Caused by Salmonella Typhi in a Non Sickler Patient: A Rare Case Finding

Abstract

A splenic abscess which is caused by Salmonella typhi is a very rare complication of typhoid fever. We are reporting a case of a 14 year old female who presented with fever and pain in the abdomen. She was treated for fever of unknown origin in a rural hospital and was then admitted to our hospital after 15 days . She complained of fever and pain in the abdomen. On ultrasound, multiple splenic abscesses were seen. A USG guided aspiration was done and the aspirated material was received for culture, which was found to be positive for Salmonella typhi. A blood and stool culture which were done were negative and the Widal test showed a positive result with titres of TO 1:320 and TH 1:320.No predisposing factor was found in our case. Sickling was negative and HIV and HBsAg screening showed negative results. She responded favourably to the antibiotics which were given as per our antibiotic sensitivity report.

A Case of Typhoid Splenic Abscess: A Case Report and Literature Review

“…In our patient, these two modalities, as well as pus and blood cultures, played essential role in establishing the diagnosis. This study supports evidence from previous observations that typhoid splenic abscesses could present solitary/unilocular lesions (3,12,13) or multiple/multilocular lesions (4,5,7,8,10,11).…”

“…Typhoid splenic abscess is a rare clinical entity, which was formerly believed to occur in immunocompromised patients (3,4); however, our patient was immunocompetent, indicating the occurrence of this condition regardless of the patient's immune status.…”

“…Treatment of typhoid splenic abscess is controversial because no randomized trials were conducted. Splenectomy along with antibiotics is regarded as the treatment of choice by many physicians (5,7,8,11,13); however, our case, as well as other cases, showed that percutaneous abscess aspiration with appropriate antibiotics coverage could be as effective as splenectomy (3,4,10,12). Furthermore, there is no consensus on the duration of antibiotic therapy, which should be adapted to each case.…”

“…Abdomen ultrasonography and CT are very helpful in the early detection of the splenic lesion with abdomen CT being most sensitive and specific modality, moreover, microbiological study of blood and aspirated pus is essential to identify the etiological agent (3)(4)(5)(7)(8)(9)(10)(11)(12)(13). In our patient, these two modalities, as well as pus and blood cultures, played essential role in establishing the diagnosis.…”

Relapse of typhoid fever following delayed response to meropenem: A case report and review of previously published cases indicating limited clinical efficacy of meropenem for the treatment of typhoid fever

“…HIV, malnutrition [ 2 ], [ 4 ], [ 10 ], [ 13 ], [ 14 ]; structural and functional abnormalities, e.g. malignant tumours [ 15 ], haemoglobinopathies (Sickle cell disease) [ 16 ], [ 17 ], cysts [ 18 ], neurologic disorders [ 19 ]; infants/young children, elderly patients [ 2 ], [ 4 ], [ 10 ], [ 13 ]; patients with limited access to proper health care, e.g. patients from remote areas or low-income countries, patients affected by poverty [ 2 ], [ 4 ], [ 13 ]; delay in diagnosis and treatment [ 2 ], [ 4 ], [ 13 ]; inappropriate antibiotic treatment, e.g.…”