Culture-negative cryptogenic splenic abscess in an immunocompetent host with recurrent misdiagnosis as pleural effusion: a case report with a review of the literature - Report - MDSpire

Culture-negative cryptogenic splenic abscess in an immunocompetent host with recurrent misdiagnosis as pleural effusion: a case report with a review of the literature

  • By

  • Andrio Palayukan

  • Ummi Maimunah

  • June 26, 2026

  • 0 min

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Clinical Report: Culture-Negative Cryptogenic Splenic Abscess Case Study

Background

Splenic abscess is a rare but serious condition that can be difficult to diagnose due to its nonspecific symptoms, often mimicking other diseases such as pneumonia. The mortality rate for splenic abscesses remains significant despite advancements in treatment.

Data Highlights

ParameterInitial1 Week Later
LeukocytosisYesPersistent
CRPElevatedNot specified
ProcalcitoninNormalElevated

Key Findings

  • The patient was initially misdiagnosed with pneumonia and pleural effusion.
  • Computed tomography confirmed the presence of a splenic abscess.
  • Culture results were negative despite the presence of significant clinical symptoms.
  • Empirical antibiotic therapy was initiated targeting gram-negative organisms and anaerobes.

Clinical Implications

Clinicians should maintain a high index of suspicion for splenic abscess in patients presenting with unexplained abdominal pain and fever.

Conclusion

This case highlights the diagnostic challenges associated with splenic abscesses.

Related Resources & Content

  1. Intensive Care Medicine, 2008 -- Cryptococcal Infection in the Pleura of an Immunocompromised Individual
  2. Infection, 2025 -- Effective Treatment of Extensive Inoperable Liver Abscesses Using Antibiotic Therapy
  3. Frontiers in Pediatrics, 2026 -- Suspected chest malignancy hiding Aggregatibacter actinomycetemcomitans lung infection - Case report and review of literature
  4. IDSA 2024 Guideline Update on the Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation of Complicated Intra-abdominal Infections
  5. Splenic Abscess - StatPearls - NCBI Bookshelf
  6. Frontiers in Pediatrics — Mycobacterium abscessus infection in a young man with cystic fibrosis: a case report and literature review
  7. Molecular diagnosis of campylobacter splenic abscess in an immunocompetent adolescent
  8. The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update
  9. IDSA 2024 Guideline Update on the Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation of Complicated Intra-abdominal Infections in Adults, Children, and Pregnant People
  10. Splenic Abscess - StatPearls - NCBI Bookshelf
  11. EUS-guided transmural drainage of a splenic abscess - PubMed

Original Source(s)

Culture-negative cryptogenic splenic abscess in an immunocompetent host with recurrent misdiagnosis as pleural effusion: a case report with a review of the literature

  • by Andrio Palayukan, Ummi Maimunah

  • June 26, 2026

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