Splenic mass of uncertain etiology in a 15‐year‐old male patient: a case report

• Published in: Acute medicine & surgery Vol. 7; no. 1; pp. e464 - n/a
• Main Authors: Hisamura, Masaki, Mitsui, Daichi, Kawaguchi, Yumi, Oshio, Sadayuki, Asano, Yoshitaka, Kameda, Shinya, Nakamura, Motohiro, Chida, Sachiko, Suzuki, Mio, Koshimizu, Kenji
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2020; John Wiley and Sons Inc
• Subjects: Abdomen; Abdominal pain; Abscesses; Antibiotics; Blood tests; Body temperature; Case Report; Case Reports; Cysts; Endocarditis; Etiology; fasting therapy; fosfomycin; Hospitals; Infections; intraabdominal infection; lymphangioma; Magnetic resonance imaging; Neutrophils; Pain; Patients; Pelvis; Spleen; splenic abscess; splenic disease; splenic mass; Surgery; Ultrasonic imaging; lymphangioma; fasting therapy; splenic abscess; Abdominal pain; splenic disease; fosfomycin; intraabdominal infection; splenic mass
• ISSN: 2052-8817; 2052-8817
• DOI: 10.1002/ams2.464

Background There are few reports on spleen masses, and solitary splenic abscesses with abdominal pain have not been reported in younger age groups. We report a case of a splenic mass of uncertain etiology in a 15‐year‐old boy. Case Presentation A 15‐year‐old boy visited the emergency department with abdominal pain. Abdominal ultrasonography revealed a thin‐walled multilobular splenic cyst. Computed tomography revealed a cystic shadow and a septate structure in the spleen. Magnetic resonance imaging examination revealed a high‐signal region on the T2‐weighted image. The neutrophil ratio in the white blood cell count of 8,330/µL was high (80%), and splenic abscess could not be ruled out. Thus, therapy with 2 g/day fosfomycin was initiated. Abdominal pain disappeared on day 3 of hospital stay, and the patient was discharged on day 8. Conclusion Antibiotic therapy can be effective against very acute onset splenic abscesses, although surgical treatment is usually carried out. We report a rare case of splenic abscess successfully managed without surgical therapy. Aggressive treatments, such as surgery, might not be necessary in patients with splenomegaly without a history of malignant tumor formation and those responsive to drug treatment.