Splenic abscess as a complication of HIV-AIDS: clinical case

Abstract

Introduction: Splenic abscess is a rare entity but it occurs in up to 72% of immunologically compromised patients such as type 2 diabetes mellitus, immunohematological disorders, acquired immunodeficiency syndrome. To date, around 1000 cases have been described in the world medical literature. Clinical case: A 27-year-old male with a history of multiple hospitalizations and transfusions for dengue hemorrhagic fever, HIV (+) seven years ago with self-suspended treatment five months ago. She went to the emergency room due to abdominal pain in the epigastrium of three weeks' evolution accompanied by hyporexia, asthenia, and adynamia with hematochezia on one occasion, vomiting coffee grounds on one occasion with respiratory difficulty and dyspnea, denying fever or cough. Physical examination revealed moderate dehydration, pale integuments, tachypnea, and wheezing in the left hemithorax with wheezing in the right hemithorax, abdomen with signs of peritoneal irritation, vital signs: Blood pressure 100/60mmHg, heart rate 154/min, breaths 28/min, temp. 36.8oC. Diagnosis of probable community-acquired pneumonia plus upper gastrointestinal bleeding, severe dehydration and HIV, hypovolemic shock, and septic are included. Laboratories: hemoglobin 5.5g/dL, leukocytosis (31000/103/µl). The patient was admitted to the operating room for an exploratory laparotomy, a splenic abscess was identified on the diaphragmatic side and a splenectomy was performed. Discussion: The abscess splenic can present unique (60-70%), as it was in our case, or multiple (30-40%), the mortality can be 13% when it is unique and 22% when it is multiple. Conclusions: This case associated with HIV-AIDS is the first in our hospital.