INTRODUCTION: Isolated splenic cysts are rare in children, potentially life-threatening, and often difficult to diagnose. We introduce a complicated case with bacterial superinfection and abscessing, to facilitate recognition and early diagnostics, and discuss about best treatment options.

CASE REPORT: 5-year-old boy brought to the ER by high fever, abdominal pain and vomiting. In the blood test showed leukocytosis with elevated acute phase reactants, negative blood culture and positive stool culture for Salmonella serogroup D. In the chest radiograph was observed a left basal infiltrated with pleural effusion, and in the abdominal ultrasound, a large cystic intrasplenic lesion. With the diagnosis of giant splenic abscess, intravenous antibiotic treatment and repeated percutaneous drainage were established until the definitive surgery with cystic partial removal and capsule fenestration. In the culture of the abscess it grew a Salmonella of the same serogroup. Histopathological examination of the specimen was consistent with primary epithelial cyst.

CONCLUSIONS: Splenic cysts should be considered in the differential diagnosis of any patient with signs suggestive of pathology in the left upper quadrant. In recent years there has been great progress in its handling that in the case of children it is usually conservative.

KEY WORDS: Epithelial cyst; splenic abscess; Splenectomy; Children