Introduction:

Splenic abscess (SA) is a rare entity, most commonly (72%) observed in immunocompromised patients. Nearly 1000 cases of splenic access have been reported in the literature. The incidence in adults and children with leukemia is 7.2 and 1% respectively. From an epidemiological point of view, it is most common in adults and elderly people, with no differences between the genders.

Case report:

A sixteen-year old immunodepressed female presented with a two-month history of left upper abdominal pain, productive cough and malaise, hepatomegaly and splenomegaly, a pericardial friction rub, and left basal hypoventilation. Hemoglobin 3.7 g/dl, hematocrit. 11.4% platelet count 84.0 × 103, RBC 1.14 × 106, WBC 14.1 × 103, neutrophils 89%, eosinophils 1%. Abdominal CT scan revealed a large hypodense area on upper splenic pole (7.3 cm × 6.6 cm) with multiple intraparenchymal hypodense zones (5 mm in diameter) and an enlarged spleen (15 cm long approx.). Total splenectomy was performed and antimicrobial therapy including imipemen and vancomycin was given.

Conclusion:

Splenectomy, particularly in immunodepressed patients, is the treatment of choice for patients with splenic abscesses because of its high rates of success and good prognosis.