Abstract
Splenic abscesses are rare and potentially fatal, and require an early diagnosis and intervention. However, few reports have described splenic abscesses with diabetic foot gangrene. Therefore, we report a case of splenic abscess associated with diabetic foot gangrene, along with a review of the relevant literature. The patient, a 47-year-old man on dialysis for type 2 diabetes mellitus, had a skin ulcer on the lateral right foot. The infection rapidly progressed, and the patient was emergently admitted to the hospital. Although antibiotics were administered intravenously and debridement were performed on the 1st and 12th day, the infection remained uncontrolled. Finally, below-knee amputation was performed on the 48th day and wound healing progressed favorably after surgery. However, the patient developed a fever again and blood tests revealed a prolonged inflammatory reaction. Since a computed tomography scan revealed a splenic abscess, some fistula catheters were placed through the abscess in the spleen under endoscopy on the 67th day. Genetic testing of the wound culture, splenic abscess, and blood culture revealed the same Staphylococcus aureus infection. After the implantation of the catheters, the splenic abscess demonstrated marked improvement. The possibility of a splenic abscess should be kept in mind in cases of prolonged inflammatory findings, since we do not think a splenic abscess is suspected in the early stages.
Contrast-enhanced computed tomography findings on day 57.
Fullsize Image
The red arrow indicates a splenic abscess.
