A Case of Multiple Splenic Abscesses during Long-term Steroid Therapy

Abstract

A 73-year-old woman was admitted to our hospital for further examination of anemia after a traffic injury.
Blood tests showed anemia and high-grade inflammation. Computed tomography revealed multiple splenic abscesses. Since the inflammation did not improve with systemic antibiotic treatment, splenectomy was performed. After this operation, ileus was observed, and repeat laparotomy was performed. Focal stenosis was observed in the terminal ileum, and this was treated with ileocecal resection. The resected specimen showed a simple ulcer. Bacteremia from this ulcer was suspected to be the cause of the splenic abscesses. The ulcer was a simple ulcer of the entire circumference of the resected specimen. It was believed that bacteremia developed from the small intestinal ulcer, resulting in multiple splenic abscesses, in the presence of immune depression due to long-term administration of steroids.