Primary Splenic Abscess: A Case Report

Abstract

Splenic abscess is a relatively uncommon infection with a very low incidence but has high mortality if left untreated. It is usually associated with a predisposing factor and requires early diagnosis and urgent management either in medical or surgical modality. Drainage of the abscess is also rapidly recognised treatment option. Herein, the authors presented a case of 56-year-old male with fever, vomiting, and abdominal pain. Computed Tomography (CT) abdomen revealed a large splenic abscess with subdiaphragmatic extension and open splenectomy was performed. Histopathology confirmed the presence of necrotising granulomatous lesions in the spleen, and tuberculosis was ruled out. The diagnosis was provisionally suggested as cat scratch disease, and the patient made a complete recovery. A high level of suspicion is needed for the diagnosis of splenic abscess, owing to its non specific presentation is often non specific. CT imaging is the diagnostic investigation of choice, and investigations should target the identification of the primary foci of infection. Surgical management is still widely preferred, but more research is needed to evaluate medical management and percutaneous drainage.