Rationale: Melioidosis is an emerging infectious disease caused by Burkholderia pseudomallei. To our knowledge, there have been very few cases of splenic abscesses due to melioidosis in Hainan, China.
Patient concerns: The patient was a 55-year-old male farmer, who was admitted in our hospital with persistent left epigastric dull pain accompanied by chills and febrile. One month before, the patient presented with persistent abdominal pain. After received anti-infection therapy, the subjective symptoms eased slightly, but recently he suffered from intermittent abdominal pain again.
Diagnoses: Bacteria isolated from splenic pus were identified as B. pseudomallei by the Phoenix-100 system and indirect immunofluorescence.
Interventions: The patient was treated by surgical excision and anti-infection therapy.
Outcomes: The patient was then treated with intravenous ceftazidime and oral trimethoprim-sulfamethoxazole for 2 weeks and his clinical symptoms improved.
Lessons: In endemic areas, B. pseudomallei should be considered as a causative organism of splenic abscess in patients with established risk factors. The isolation of B. pseudomallei from abscess sites is crucial to improve clinical outcomes by appropriate antimicrobial therapy coupled with surgical drainage.