Emphysematous Splenic Infection in the Setting of Disseminated Klebsiella pneumoniae

Abstract

Background: Splenic infections present generally in the setting of previous splenic trauma or in patients with relative immune compromise. Primary infections or hematologic spread from remote sites are typical etiologies. Case Presentation: We encountered a 71-year-old diabetic male with history of pancreaticoduodenectomy who presented with Klebsiella bacteremia and a necrotizing infection of the spleen with small, diffuse abscesses throughout the lungs and liver. Imaging was significant for portal venous gas and pneumoperitoneum secondary to the patient's infection. The patient underwent splenectomy and was treated with long-term antibiotic therapy. Diagnostic work-up did not yield a definitive causative etiology other than potential primary infection from one of the affected sites, though colonoscopic evaluation is pending. Conclusion: Splenic abscesses may be treated with limited drainage or may require splenectomy if multi-focal infection exists.