Multidisciplinary Management of Single Organism Emphysematous Splenitis Without Splenectomy: A Case Report.

Abstract

Emphysematous splenitis traditionally requires a splenectomy, resulting in life-long consequences for the patient. Clostridium perfringens is often seen in an immunocompromised population. This case demonstrates a multidisciplinary team approach consisting of percutaneous drainage and a prolonged intravenous and oral antibiotic regime, including ceftriaxone and metronidazole, as well as amoxicillin and clavulanic acid, to provide a successful outcome in an elderly immunocompetent female. This negated the need to proceed to the traditional operative management of splenectomy and validates an equitable conservative approach to treat a C. perfringens-induced emphysematous splenic infection. This approach was undertaken and was likely successful secondary to the haemodynamic stability and immunocompetent baseline of the patient. Her immunocompetency could be maintained due to the non-operative management and should therefore be considered if the clinical situation allows.