We report the case of a 5-year-old male patient with multiple aseptic splenic abscesses associated with Behçet's disease. The patient visited Gachon University Gil Hospital with fever, abdominal pain, and acute watery and bloody diarrhea, and reported a 2-year history of chronic abdominal pain and intermittent watery diarrhea. He was treated with antibiotics at a local clinic for fever and cervical lymph node swelling. Additionally, he had recurrent stomatitis. A colonoscopy showed multiple well-demarcated ulcerations throughout the colon, and abdominal computed tomography showed multiple splenic abscesses. Pathergy and HLA-B51 tests were positive. Investigations did not reveal any infectious organisms in the aspirate obtained via ultrasound-guided fine needle aspiration. After steroid treatment, all symptoms and multiple aseptic splenic abscesses resolved. However, oral ulcers, genital ulcers, and abdominal pain recurred after tapering the steroids. Infliximab treatment improved the patient's symptoms. However, 5 months after the treatment, the symptoms recurred. The treatment was changed to include adalimumab. Subsequently, the patient's symptoms resolved and colonoscopic findings improved. No recurrence was noted after 3 months of follow-up.

Citations

Citations to this article as recorded by  

• Multiple aseptic abscesses and pulmonary involvement in a child with Behcet’s disease phenotype: a case report
  Yucan Zheng, Guiping Kong, Hongmei Guo, Zhifeng Liu, Kunlong Yan
  Frontiers in Immunology.2025;[Epub]     CrossRef
• Aseptic Abscess of the Spleen as an Antecedent Manifestation of Behçet’s Disease
  Mohamed Jazeer, Diroji Antony, Mayurathan Pakkiyaretnam
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• Treatment with Biologic Drugs in Pediatric Behçet’s Disease: A Comprehensive Analysis of the Published Data
  Ezgi Deniz Batu, Seher Sener, Veysel Cam, Nuray Aktay Ayaz, Seza Ozen
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• Case report: Aseptic splenic abscesses in childhood-onset systemic lupus erythematosus
  Shobashenee Sritharan, Peter Sie-Teck Lau, Kamilah Manan, Anand Mohan
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• Successful management of a case of intestinal Behçet’s disease with a splenic abscess by intensified immunosuppressive therapy without splenectomy
  Noriko Sato, Fumiya Yamaide, Ryohei Shibata, Taiji Nakano, Akiko Yamaide, Takeshi Saito, Naoki Shimojo
  Modern Rheumatology Case Reports.2022; 6(2): 266.     CrossRef
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  Dimitri Poddighe, Zaure Mukusheva, Kaisar Dauyey, Maikesh Assylbekova
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Klebsiella pneumoniae (K. pneumoniae) can at times cause invasive infections, especially in patients with diabetes mellitus and a history of alcohol abuse. A 61-year-old man with diabetes mellitus and a history of alcohol abuse presented with abdominal and anal pain for two weeks. After admission, he underwent sigmoidoscopy, which revealed multiple ulcerations with yellowish exudate in the rectum and sigmoid colon. The patient was treated with ciprofloxacin and metronidazole. After one week, follow up sigmoidoscopy was performed owing to sustained fever and diarrhea. The lesions were aggravated and seemed webbed in appearance because of damage to the rectal mucosa. Abdominal computed tomography and rectal magnetic resonance imaging were performed, and showed a perianal and perirectal abscess. The patient underwent laparoscopic sigmoid colostomy and perirectal abscess incision and drainage. Extended-spectrum beta-lactamase-producing K. pneumoniae was identified in pus culture. The antibiotics were switched to ertapenem. He improved after surgery and was discharged. K. pneumoniae can cause rapid invasive infection in patients with diabetes and a history of alcohol abuse. We report the first rare case of proctitis and perianal abscess caused by invasive K. pneumoniae infection.

Citations

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• Microbiota in adult perianal abscess revealed by metagenomic next-generation sequencing
  Jian-Chen Hong, Jian-Sheng Chen, Zai-Jie Jiang, Zhi-Chuan Chen, Ning Ruan, Xiang-Ping Yao, Rosemary C. She
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• An Unusual Case of Proctitis and Rectal Abscess due to Irritants byArtemisia asiaticaSmoke (Ssukjwahun)
  Seunghyup Kim, You Sun Kim, Seo Hyun Kim, Dong Hoon Lee, Se Jun Park, Seo Young Yun, Dae Young Kim, Jeonghun Lee, Jeong Seop Moon
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Peritonsillar abscess is a common deep throat infection. Early diagnosis and prompt, appropriate management of a peritonsillar abscess prevents mortality. A 45-year-old woman on steroids for an ulcerative colitis (UC) exacerbation presented with sore throat and multiple skin ulcers on her left forearm and right foot. Computed tomography of the neck revealed a peritonsillar abscess. Gram staining and culture of the abscess were negative, and a skin biopsy suggested pyoderma gangrenosum (PG). The final diagnosis was peritonsillar involvement of steroid-refractory PG-associated UC. The patient showed a complete response to infliximab. Here, we report a case of successful infliximab treatment for peritonsillar involvement of steroid-refractory PG-associated UC.

Citations

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