A rare case of a massive unilocular typhoid splenic abscess in Sri Lanka: A Case Report

Splenic abscesses are commonly reported in patients with immunosuppression, abnormalities in the spleen due to trauma or haemoglobinopathies and diabetes. Typhoid fever causing isolated splenic abscess is a rarity. We report a case of a splenic abscess in a previously well patient without any predisposing risk factors and previous illness clinically suggestive of typhoid fever.A 22-year-old Sri Lankan woman was admitted to a tertiary care hospital in Sri Lanka with a 2-week history of high-grade fever with chills and rigors, and abdominal fullness. Palpation revealed a large firm mass in the left upper quadrant which was confirmed as a massive spleen on ultrasonography. Contrast CT of the abdomen showed a large hypodense lesion within the spleen. A drain was inserted radiologically which drained a purulent fluid. Culture of the drain fluid grew Salmonella ser. Typhi. She made an excellent recovery with antibiotics.Typhoid is a rare but reported cause of splenic abscesses. It could occur even in patients with no apparent risk factors. Early diagnosis and treatment lead to an excellent clinical outcome.