Complicated Splenic Abscess Presenting with Cholestatic Jaundice and Fatal Septic Shock in a Diabetic Patient: A Case Report and Review of the Literature

Background: Splenic abscess is a rare but potentially fatal condition. Its diagnosis is often delayed because of non-specific clinical manifestations, particularly in immunocompromised patients. Diabetes mellitus is a recognized risk factor.Case presentation: We report the case of a middle-aged diabetic patient who presented with prolonged abdominal pain, cholestatic jaundice, and systemic inflammatory response. Imaging revealed splenomegaly with a large heterogeneous splenic lesion associated with a peri-splenic collection containing air bubbles, suggestive of a complicated splenic abscess. Emergency splenectomy and drainage were performed; however, the patient rapidly deteriorated and died on postoperative day one due to refractory septic shock.Conclusion: This case highlights the diagnostic challenges, rapid progression, and high mortality associated with splenic abscesses in diabetic patients. Early recognition, aggressive resuscitation, and timely intervention are crucial to improving outcomes.