Synchronous splenic and intracerebral abscesses in a child: a case report

Abstract

Splenic abscess is a life threatening condition which is very rare in children. There is usually an infective focus or predisposing factors such as immunodeficiency towards developing splenic abscesses. Only one case of splenic abscess with brain abscesses in an adult has been reported in English literature. We therefore report a case of an 11-year-old boy who was otherwise healthy but presented with fever and weight loss of two months’ duration, right upper abdominal pain, vomiting, hypochondrial tenderness of 1-week duration, and later on developed a left hemiplegia and right facioparesis two days prior to presentation. Diagnosis of splenic abscess and right intracerebral abscesses were confirmed with abdominopelvic ultrasound scan, abdominal and cranial computerized tomographic scans. He subsequently had percutaneous ultrasound guided drainage of the splenic abscess which was not successful necessitating splenectomy with aggressive antibiotics treatment to which the patient responded to with resolution of the brain abscesses and full recovery of power in all the limbs. This report is aimed to highlight the need for increased suspicion of splenic abscesses in children who are apparently immunocompetent and to add to the knowledge of management of this rare condition in children. We conclude that splenic abscesses with intracerebral abscess is a rare but life threatening condition which is amenable to treatment with drainage of abscess and aggressive guided antimicrobial therapy