Case report of successful partial splenectomy for a splenic abscess in a paediatric patient

Abstract

HighlightsSplenic abscess is rare conditions seen in children.Salmonellosis is a common cause of infection in splenic abscess.Splenic abscess can be managed with partial splenectomy.

An unusual case of abdominal pain and splenomegaly in a paediatric patient

“…Isolated splenic abscesses are a dangerous, but fortunately uncommon condition in children requiring a high degree of clinical suspicion. 1 – 3 The triad of fever, upper quadrant abdominal pain, and leukocytosis is not specific but should raise suspicion for a splenic abscess. 2 , 3 , 6 In addition to these signs and symptoms, patients may complain of left shoulder pain due to involvement of diaphragmatic pleura, and shortness of breath in the presence of splenomegaly and pleural effusion.…”

“…A clinical presentation of fever, upper abdominal pain, and leukocytosis should raise the possibility of splenic abscess; risk factors include infections at a distant or contiguous site, splenic trauma, hemoglobinopathies, and an underlying state of immunocompromise. 1 Due to the wide variety of causative pathogens, broad empiric antimicrobial coverage and comprehensive evaluation for the source of infection are required. Historically, the treatment strategy for splenic abscesses included splenectomy and antimicrobial therapy; however, accumulated evidence has demonstrated that percutaneous aspiration with antimicrobial therapy has a high success rate.…”

“… 2 – 4 Whenever possible, spleen-preserving techniques should be used in order to maintain the immunologic function of the organ. 1 , 3 …”

“…[2][3][4] Whenever possible, spleen-preserving techniques should be used in order to maintain the immunologic function of the organ. 1,3 Fusobacterium species are fastidious anaerobic bacteria that are present in large populations in the oral cavity of both healthy and diseased individuals. 5 Although commonly implicated as a periodontal pathogen, Fusobacterium nucleatum has also been implicated in a wide range of human diseases.…”

Splenic abscess in a child as a cause of fever of unknown origin

“…There is a clear tendency to increase the percentage of non-radical splenic interventions over total splenectomy. This results from greater awareness of the important role of spleen in the removal of encapsulated bacteria (12,14) . Percutaneous drainage is more preferable than surgical drainage due to the lack of postoperative complications, shorter hospital stay and lower treatment costs (13) .…”