Spontaneous splenic rupture secondary to salmonella bacteraemia: a case report and review of literature

Abstract

INTRODUCTION Spontaneous splenic rupture without any history of trauma is a rare and under-recognized entity in patients presenting with acute abdomen. This is a life threatening condition seen in association with various haematological malignancies, medications and blood stream infections. CASE PRESENTATION We report the case of a ninety-four-year-old male who presented to a regional Australian Hospital with abdominal pain, fever and hypotension. Imaging revealed splenic rupture. Salmonella Typhi was isolated on blood and peritoneal cultures. The patient’s Salmonella exposure was likely related to frequent consumption of raw eggs. He was managed conservatively with intravenous antibiotics to treat salmonella bacteraemia. Unfortunately, the patient died prior to discharge. DISCUSSION Salmonella bacteraemia is an uncommon cause of splenic rupture. Timely diagnosis and identification of the underlying aetiology of splenic rupture is essential for targeted management of such patients. CONCLUSION Spontaneous splenic rupture is a rare and potentially life threatening disorder which should be considered in the differential diagnosis of acute abdomen, regardless of any occurrence of trauma. Early recognition of this condition is essential to prevent the associated morbidity and mortality.