Salmonellal Splenic Abscess in the Antibiotic Era: A Latin American Perspective

Abstract

Ten cases of salmonellal splenic abscesses recently documented in various Latin American countries are discussed. All patients were adults; the mean age was 32.6 years, and there was a predominance of males (seven). Predisposing conditions were identified in four cases. All 10 cases were documented by diagnostic imaging techniques; in one case, exploratory diagnostic laparotomy was also performed. Splenectomy was performed on eight patients, while two other patients responded to long courses of intravenous antimicrobial therapy alone. One patient died as the result of perioperative splenic rupture, and two patients underwent second laparotomies because of left subphrenic abscesses. Except for one human immunodeficiency virus-infected individual, all patients were immunocompetent and had large solitary lesions. Salmonella typhi was the predominant organism isolated and was recovered in six of the 10 cases.

Conservative management of isolated splenic abscess in children

“…This can probably be attributed to the commencement of antibiotic therapy initiated before referral. Almost half of our cases were associated with typhoid fever, similar to previous reports [6,7]. Allal et al [5] reported an incidence of 2% of SA in a series of 400 patients with S typhi infection.…”

“…It has also been stated that solitary SA may respond to percutaneous drainage; but for multiple or multiloculated SAs, splenectomy is the treatment of choice [23]. In our series, however, we found antibiotic therapy with or without percutaneous needle drainage to be completely effective in the management of solitary as well as multiple SAs including cases of SAs associated with typhoid fever where the traditional management described is splenectomy in addition to specific antibiotic therapy [6,7].…”

Splenic Abscess: A Single Institution Study and Review of the Literature

“…Allal et al reported 400 patients with S. typhi and found splenic abscesses in 8 (2%) patients; of these only one had multiple splenic abscess 19. Torres, et al20 reported 10 cases of typhoidal solitary splenic abscesses.…”

Salmonellosis and the gastrointestinal tract: More than just peanut butter

“…A reactive polyarthritis can also occur after the onset of gastroenteritis; however, this is an immune phenomenon rather than a dissemination infection. Gastrointestinal manifestations of nontyphoidal salmonellosis may include hepatomegaly, splenomegaly, cholecystitis, cholangitis, and splenic and hepatic abscesses, but these are overall uncommon [12, 59, 60]. …”