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

Introduction. Splenic abscess is a very rare extra-intestinal complication of Salmonella infection in the post-antibiotic era with the 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 110 × 80mm (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 the next step, percutaneous drainage was performed. Salmonella enteritidis was isolated from the culture; the isolate was sensitive to ampicillin, ciprofloxacin, and third-generation cephalosporins. The initially started empiric therapy with amikacin was replaced by cefriaxone. After one month, the patient was discharged for home treatment. During the six-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 a rare splenic abscess due to Salmonella enteritidis was treated successfully with a combination of percutaneous drainage, prolonged antibiotic therapy, and intensive care.