Splenic and Pancreatic Abscess Secondary to Chronic Corticosteroid Use: A Case Report and Literature Review.

Abstract

Splenic abscess is a rare but potentially life-threatening condition often associated with immunosuppressive states. We present the case of a 62-year-old man with a history of chronic corticosteroid use who developed fever, anorexia, weight loss, and left upper quadrant abdominal pain. Laboratory studies revealed leukocytosis and elevated inflammatory markers. Contrast-enhanced computed tomography identified multiloculated abscesses in the spleen and pancreatic tail. The patient underwent exploratory laparotomy, splenectomy, and distal pancreatectomy, with a favorable postoperative course complicated only by a superficial surgical site infection. Splenic abscess typically results from hematogenous spread, and its diagnosis is often delayed due to nonspecific symptoms. Imaging, particularly contrast-enhanced CT, is critical for early detection. Management strategies include percutaneous drainage or surgical intervention, depending on the patient's clinical status. Although corticosteroid-induced immunosuppression is a rare risk factor, it should be recognized as a potential cause. Early diagnosis, source control, and targeted antibiotic therapy are crucial for optimizing patient outcomes.