Calcified splenic abscess, colonic fistula and ascitis in a chronic carrier of Salmonella typhi

We report the unusual case of a patient with chronic carriage of Salmonella typhi who presented with partially calcified splenic abscess linked to col ic fistula and ascitis. The colic fistula could be secondary to ischemic ne crosis by left colon compression due to spleen large abscess. Fistula was e videnced by abdominal computed tomography scan and confirmed by barium enem a. The possible etiologies of ascitis are either tuberculosis or ascitic pe ritonitis secondary to the fistulisation; nevertheless, the role of segment ary portal located hypertension cannot be completely excluded. The splenic abscess was probably due to Salmonella typhi which was only isolated from s tool specimens. The calcified splenic abscess was the evidence that the inf ection had occurred first. In addition, the isolation of Salmonella typhi i n stool cultures six months after the subject had returned from the Comores proved the chronic carriage. Treatment by splenectomy and left colectomy w as successful in this patient.