nontyphoidal salmonella species are important food borne pathogens and acute gastroenteritis is the most common clinical manifestation accounting for about 70% of cases .
splenic abscess is a very rare complication of nontyphoidal salmonella infections since the presence of antibiotics . here
a 63-year - old woman from eastern part of turkey was admitted with the complaint of back pain , vomiting and nausea since 20 days .
laboratory findings were as follows : white blood cell ( wbc ) count was 14670/mm ( 88.9% polymorphonuclear cells ) , haemoglobin 9.5 g / dl , platelet count 183000/mm , erythrocyte sedimentation rate 76 mm / h , and c - reactive protein ( crp ) 58 mg / dl ( normal value < 5 mg / l ) .
an abdominal ultrasound revealed a hypoechogenic cystic structure with a diameter of 6172 mm in the upper part of the spleen with calcifications ( figure 1 ) .
salmonella enteritidis was yielded from culture of the samples of the abscess obtained during the operation .
it was sensitive to ampicillin , cotrimoxazole , cephalosporins of third generation , and ciprofloxacin . 

after isolation of the s. enteritidis from abscess , the patient was questioned in detail , it was learned that the patient had diarrhoea and fever existed 2 days and recovered without antibiotic treatment one month ago .
the usual clinical presentation of nontyphoidal salmonella infection is self - limited gastroenteritis , however bacteraemia and focal extraintestinal infections may occur .
risk of bacteraemia and focal extraintestinal infections are high in individuals with comorbidities such as malignancy , human immunodeficiency virus ( hiv ) , diabetes mellitus , and patients receiving immunosuppressive therapy .
invasive nontyphoidal salmonellae disease is a major cause of mortality in african children and hiv - infected african adults .
any tissue or organ may be seeded hematogenously by nontyphoidal salmonella and may form a local infection , become obvious months or even years after the initial bacteraemia producing characteristic clinical syndromes .
some serovars of salmonella show a higher tendency for causing bacteraemia and these serovars differ in different countries . non - typhoidal salmonella serovars s. typhimurium and s. enteritidis are cause of invasive disease in industrialized countries , also they are predominant in african region . 

s. enteritidis had the highest blood invasiveness among non - typhoidal salmonella species in malaysia . our patient had diabetes mellitus and probably s. enteritidis bacteraemia occurred during the course of diarrhoea one month ago which lead to bacterial seeding in the spleen .
antibiotic treatment for patients with mild to moderate gastroenteritis due to non - typhoidal salmonella is not indicated in healthy adults .
however antimicrobial therapy should be initiated for patients who are severely ill and for patients with risk factors for extraintestinal spread of infection .
the symptoms of splenic abscess are usually nonspecific the most frequent symptoms and signs are fever , abdominal pain and tenderness over left upper quadrant , splenomegaly , leucocytosis , and left lower chest abnormalities .
our patient had back pain , vomiting , nausea and leucocytosis which were not specific for splenic abscess .
computed tomography remains the gold standard and the most sensitive tool for the definitive diagnosis of splenic abscess .
ultrasonography has 76% , ct has 96% sensitivity for the detection of abdominal masses . in our patient ,
diagnosis was confirmed with ct . at present , splenectomy is the gold standard for treatment while ultrasound- or ct - assisted percutaneous drainage and antimicrobial therapy can be considered as therapeutic alternatives especially in the presence of an isolated abscess .
we preferred splenectomy for treatment as the causative microorganism was not known initially . in conclusion , although non - typhoidal salmonella gastroenteritis is rarely resulted with splenic abscess , patients with comorbities are at increased risk .
 splenic abscess is a very rare complication of non - typhoidal salmonella infections . 
 we report a case of splenic abscess caused by salmonella enteritidis . 
 the patient is a 63-year - old woman with diabetes mellitus and underwent splenectomy . 
 this case suggests that the patients with comorbities are at increased risk for invasive infections in non - typhoidal salmonella infections . 