Splenic abscess due to Salmonella enteritidis after abdominal trauma resolved by interventional radiological methods-case report

Milan B Pantelic; Tamara Vučinić; Milica Stanucević; Miloš Dujović; Maša Pantelić

doi:10.5937/afmnai42-53491

Milan B Pantelic Department of radiology, Zvezdara University Health Center, Belgrade, Serbia
Tamara Vučinić Department of radiology, Zvezdara University Health Center, Belgrade, Serbia
Milica Stanucević Department of radiology, Zvezdara University Health Center, Belgrade, Serbia
Miloš Dujović Department of radiology, Zvezdara University Health Center, Belgrade, Serbia
Maša Pantelić Department of gastroenterology and hepatology, Zvezdara University Health Center, Belgrade, Serbia

DOI: https://doi.org/10.5937/afmnai42-53491

Keywords: salmonella enteritidis, splenic abscess, percutaneous drainage

Abstract

Introduction: Splenic abscess is a very rare extra-intestinal complication of Salmonella infection in the post-antibiotic era with incidence between 0.14% and 2%. It usually follows bacteremia due to varied etiologies such as trauma, infective endocarditis, intravenous drug abuse, immunodeficiency status (AIDS, diabetes mellitus).

Case report: An 82-year-old woman presented with complaints of upper abdominal pain, fever and nausea for two weeks following abdominal trauma. Computed tomography scan of the abdomen showed hypodense lesion measuring 110x80mm(CCxLL) with minimal peripheral contrast enhancement, diagnosed as a splenic abscess.

The patient underwent an ultrasound and X-ray guided percutaneous needle aspiration to collect a sample of pus for microbiological analyses and in next step percutaneus drainage was performed.

Salmonella enteritidis was isolated from culture; the isolate was sensitive to ampicillin, ciprofloxacin and third-generation cephalosporins, and antibiotic therapy with ceftriaxone was started. After one month, the patient was discharged for home treatment. During the 6-month follow-up, there were no recurrent symptoms and a follow-up CT scan showed a normal-sized spleen with thin, low-density zones under the capsule-sequels of inflammation.

Conclusion: Only a few cases of splenic abscess caused by Salmonella enteritidis have been described in the literature and they were mostly treated with splenectomy. This case of rare splenic abscess due to Salmonella enteritidis was treated successfully with combination of percutaneous drainage, prolonged antibiotic therapy and intensive care.

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