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Open Access Case report

Multiple aseptic splenic abscesses in a 15 year old patient

Alexander J Jordan1, Klaus-Peter Becker2, Metin Sertemir3, K Wolfgang Neff3, Rüdiger Adam1, Horst Schroten1 and Tobias Tenenbaum1*

Author Affiliations

1 Paediatric Infectious Diseases, Department of Paediatrics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany

2 Institute for Medical Microbiology and Hygiene, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

3 Institute of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

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BMC Gastroenterology 2014, 14:20  doi:10.1186/1471-230X-14-20

Published: 6 February 2014

Abstract

Background

Splenic abscesses in children are rare. In recent years aseptic abscesses have been recognized as a new disease entity, especially in adults.

Case presentation

We present a rare case of a 15 year old girl with aseptic abscesses, in whom antibiotic therapy comprising metronidazole and meropenem was partly beneficial in improving the patient’s clinical condition and inflammatory parameters. Eventually corticosteroid therapy led to complete and long lasting resolution of symptoms. Further diagnostic work-up revealed autoimmune thyroiditis, but no signs of inflammatory bowel disease.

Conclusion

Aseptic splenic abscesses should always prompt clinicians to initiate further diagnostics to determine a potential underlying condition and a regular follow-up. Anaerobic bacteria may play a role in the pathogenesis of the disease and besides corticosteroid treatment antibiotics covering anaerobes may be beneficial.

Keywords:
Abscess; Aseptic; Anaerobic bacteria; Metronidazole; Inflammatory bowel disease