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This report focuses on the management and outcomes of Aseptic Abscess Syndrome using immunosuppressive therapy.

March 5, 2026Internal Medicine0 citationsOpen Access

Successful Immunosuppressive Therapy for Aseptic Abscess Syndrome Presenting with a Fever of Unknown Origin

SOShingo OkamotoSaitama Red Cross Hospital KEKazuo EguchiSaitama Red Cross Hospital SMSusumu MarutaSaitama Red Cross Hospital

Key Points

This report focuses on the management and outcomes of Aseptic Abscess Syndrome using immunosuppressive therapy.
Case report of a 70-year-old woman with symptoms of fever and abscesses
Diagnostic imaging with computed tomography (CT) scan to identify splenic lesions
Therapeutic intervention with corticosteroids followed by azathioprine and colchicine for maintenance therapy.
Rapid resolution of symptoms post-corticosteroid therapy
Negative cultures for infection despite the presence of abscesses
Patient remained relapse-free with the continuation of azathioprine and colchicine.

Abstract

Aseptic abscess syndrome (AAS) is a rare autoinflammatory disease characterized by sterile abscesses in various organs, and it is often associated with inflammatory bowel disease (IBD). We report the case of a 70-year-old woman with recurrent fever, multiple colonic aphthae, and painful limb nodules. A computed tomography (CT) scan revealed multiple splenic lesions, and aspiration revealed white purulent fluid. Despite the diagnosis of multiple splenic abscesses, antibiotic therapy was ineffective, and cultures from the blood and splenic aspirate were negative. AAS was suspected and immunosuppressive therapy with corticosteroids led to rapid symptom resolution. The patient remained relapse-free after administering azathioprine and colchicine maintenance therapy.

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