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Splenic Abscess Complicating Salmonella paratyphi A Infection: A Case Report and Systematic Review of Literature
Vithiya Ganesan1, T Rajendran2, Shunmuga Sundaram Ponnusamy3
1Professor of Microbiology, Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India, Orcid: https://orcid.org/0000-0003-0949-2841, Corresponding Author.
Introduction:
Recently, there is an upsurge of splenic abscess due to typhoidal Salmonella in India.
Methods:
We present a case of splenic abscess caused by Salmonella paratyphi A in an immunocompetent male and conducted a systematic review of splenic abscess cases attributed to typhoidal Salmonella described between January 2001 and May 2024.
Results:
Of 33 cases reviewed, 26, 2, and 1 case each were reported from India, Sri Lanka, Turkey, Qatar, and Pakistan, respectively. S. typhi and S. paratyphi A were reported from 29 and 4 cases, respectively. Mean age was 21 years, with 13 children and 8 females. About 28 were immunocompetent and two had diabetes mellitus. Blood, pus, stool, and pleural fluid grew the isolate in 13, 20, 1, and 1 case, respectively. Ultrasonography (USG) abdomen was diagnostic in 28 cases and normal in two cases. Computed tomography (CT) abdomen was diagnostic in all the 27 cases tested. About 17, 12, and 1 patient showed multiple abscesses, solitary lesion, and multiloculated lesion, respectively. USG/CT-guided percutaneous drainage and splenectomy were performed in 25 and 7 cases, respectively. All 33 patients recovered from the infection.
Conclusion:
We aspire to raise acquaintance among health professionals regarding this uncommon entity and foresee it in pertinent contexts.
Insights
Splenic abscesses caused by typhoidal Salmonella are increasing in India. A review of 33 cases highlights Salmonella Typhi and Paratyphi A as common culprits, primarily affecting immunocompetent young adults. All patients recovered after treatment.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Radiology
Background:
- An increasing incidence of splenic abscesses attributed to typhoidal Salmonella has been observed in India.
- Typhoidal Salmonella species, including Salmonella Typhi and Salmonella Paratyphi A, are emerging pathogens causing splenic abscesses.
Purpose of the Study:
- To present a case of splenic abscess caused by Salmonella Paratyphi A in an immunocompetent male.
- To conduct a systematic review of splenic abscess cases caused by typhoidal Salmonella between January 2001 and May 2024.
Main Methods:
- A systematic review was performed on published cases of splenic abscesses caused by typhoidal Salmonella.
- Data extraction included patient demographics, clinical presentation, diagnostic imaging, causative Salmonella species, and treatment outcomes.
Main Results:
- A total of 33 cases were reviewed, with the majority originating from India.
- Salmonella Typhi and Salmonella Paratyphi A were the predominant causative agents.
- The majority of patients were immunocompetent young adults, and all cases showed favorable outcomes following treatment, including percutaneous drainage or splenectomy.
Conclusions:
- Splenic abscess due to typhoidal Salmonella is an uncommon but significant clinical entity.
- Increased awareness among healthcare professionals is crucial for timely diagnosis and management, particularly in endemic regions.
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