Splenic abscess – unusual cause of fever in an infant

Abstract

Splenic abscess in children is a rare entity and it usually oc­curs after local dissemination or hematogenous spread, es­pe­cial­ly in immunocompromised patients. Because of its rarity and nonspecific symptoms and signs, the splenic abs­cess is difficult to diagnose. We report the case of a 14-month-old girl with splenic abscesses. She was admitted to the hospital for persistent high fever, aphthous lesions and an ulcerative malleolar lesion. The laboratory tests showed leukocytosis, anemia, thrombocytosis, elevated C-reactive protein and D-dimers levels, with normal pro­cal­ci­to­nin levels. The blood culture and the culture from the lesion were negative. The abdominal ultrasound showed two hypoechogenic lesions in the spleen. She was suc­ces­sful­ly treated with wide-broad antibiotic therapy for six weeks, with a total resolution of the lesions. The pro­longed antibiotic therapy and hospitalization can lead to complications such as dysbiosis and superficial vein throm­bo­sis. This case illustrates that splenic abscess should be considered in unknown-focus fever, even in infants with no underlying conditions. Conservative therapy should be the first-line therapy for splenic abscesses in children, con­si­de­ring the importance of the immunological functions of the organ.