Typhoid Splenic Abscess: A Case Report and Literature Review

Typhoid splenic abscess is a rare clinical entity that can be fatal if left untreated. Herein, we reported a case of typhoid splenic abscess who responded to ultrasound-guided aspiration and antibiotic therapy. A 25-year-old Nepalese man with no significant medical history presented to the emergency department with fever and the left upper abdominal pain lasting for seven days. One month before his presentation to our hospital, he returned from an eight-week holiday in Nepal. Splenic abscess was diagnosed by abdomen ultrasound and enhanced-computerized tomography. The patient refused surgical intervention and ultrasound-guided abscess aspiration was performed while piperacillin-tazobactam was initiated. Blood and aspirated pus microscopy revealed Gram-negative bacilli and the culture grew Salmonella typhi, which was sensitive to piperacillin-tazobactam, ampicillin, ciprofloxacin, and ceftriaxone. Piperacillin-tazobactam was continued for 4 weeks with successful recovery. This case highlights the importance of considering typhoid splenic abscess in the differential of fever and abdominal pain in returning travelers.