Background: Splenic abscess is a rare but potentially fatal condition. Its diagnosis is often delayed because of non-specific clinical manifestations, particularly in immunocompromised patients. Diabetes mellitus is a recognized risk factor.Case presentation: We report the case of a middle-aged diabetic patient who presented with prolonged abdominal pain, cholestatic jaundice, and systemic inflammatory response. Imaging revealed splenomegaly with a large heterogeneous splenic lesion associated with a peri-splenic collection containing air bubbles, suggestive of a complicated splenic abscess. Emergency splenectomy and drainage were performed; however, the patient rapidly deteriorated and died on postoperative day one due to refractory septic shock.Conclusion: This case highlights the diagnostic challenges, rapid progression, and high mortality associated with splenic abscesses in diabetic patients. Early recognition, aggressive resuscitation, and timely intervention are crucial to improving outcomes.
Abdelhak et al. (Fri,) studied this question.