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Splenic abscess caused by Cutibacterium acnes in a patient with multiple tooth extractions
Journal article   Peer reviewed

Splenic abscess caused by Cutibacterium acnes in a patient with multiple tooth extractions

Madalyn Walsh, Nicholas Wasko, Andrew Joseph Simms and Jacob Hodges
BMJ case reports, Vol.16(1), p.e250486
01/25/2023
DOI: 10.1136/bcr-2022-250486
PMCID: PMC9884883
PMID: 36697110

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Abstract

A woman in her 40s with a history of dental abscess presenting with a 3-month history of nightly fevers, malaise, fatigue and acutely worsening left flank pain was found to have a splenic abscess replacing almost the entire splenic parenchyma on abdominal CT. Abscess aspirate showed Gram-positive rods, and both aerobic and anaerobic cultures grew (previously Propionibacterium acnes), a common member of the skin microbiome. Prior case reports of splenic abscess all involved parental inoculation via needle use. However, in the context of no percutaneous needle exposure and multiple tooth extractions immediately preceding her symptoms, the most likely source of her infection is oral flora with haematogenous or lymphatic spread to the spleen.
Abdominal Abscess Abscess - microbiology Female Gram-Positive Bacterial Infections - diagnosis Gram-Positive Bacterial Infections - drug therapy Gram-Positive Bacterial Infections - microbiology Humans Intraabdominal Infections Propionibacterium acnes Splenic Diseases - diagnostic imaging Splenic Diseases - microbiology

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