Amoebic splenic abscess: a case report

Abstract

Objective: Report a clinical case of amoebic splenic abscess and discuss its clinical characteristics, its difficult diagnosis, its clinical and surgical management. Case presentation: A 39-year-old male patient was admitted complaining of abdominal pain in the left flank region, nausea and lack of appetite, denying fever, vomiting and changes in bowel habits. Physical abdominal examination showed a tense, reactive abdomen, with pain on palpation of the left flank, with a sign of positive sudden decompression and a positive Giordano on the left. In admission, a computed tomography scan of the abdomen was performed, which showed hypodense collections in the spleen and the presence of free fluid in the abdominal cavity, with a hypothesis of splenic abscess. Splenectomy and caudal pancreatectomy were performed, and ceftriaxone and metronidazole were started. After the surgery, a secretion culture with a positive result was requested on July 05th, 2019 for direct research of Entamoeba histolytica, defining the diagnosis of splenic abscess by amoeba. The patient was discharged on July 07th, 2019 with a prescription for metronidazole to end up treatment. Conclusion: The amoebic splenic abscess is a rare pathology with few data in the literature, with difficulty and delay in the diagnosis and treatment of this pathology, which directly affects the patient’s prognosis. Therefore, it is necessary that more cases on the pathology be reported for a better understanding of the diagnosis and management of amebic splenic abscess.