Primary non-typhoidal Salmonella infection presenting as a splenic abscess in a healthy adolescent male

Isolated splenic abscess in a previously healthy patient is a rare clinical condition and remains a diagnostic dilemma. Clinical presentation is often non-specific and leads to a delay in diagnosis. Imaging studies help to elucidate the condition. Despite advances in medical diagnostics and therapeutics, splenic abscesses can cause significant morbidity and can be fatal. Although splenectomy was considered the treatment of choice in the past, recent trends have seen a shift towards more conservative management. We present the clinical case of a patient who presented to our emergency room with a chief complaint of left shoulder and left upper quadrant abdominal pain. Abdominal imaging showed an intrasplenic collection suspicious for a hemorrhage or an abscess. Percutaneous drainage was successfully performed, followed by conservative management with intravenous antibiotics. The culture of the fluid drained from the spleen was positive for Salmonella Saintpaul. The patient improved and was discharged. A high degree of clinical suspicion is necessary for early identification of a splenic abscess. Splenectomy can be avoided with the use of interventional radiological drainage.