A rare presentation of subphrenic abscess caused by Proteus mirabilis in a non-immunocompromised patient: A case report

TL;DR

A 77-year-old non-immunocompromised man had a rare subphrenic abscess caused by Proteus mirabilis, which took two years to diagnose and treat.

Contribution

This case highlights the atypical presentation and challenges in managing a Proteus mirabilis subphrenic abscess in a non-immunocompromised patient.

Findings

The patient had a 2-year history of febrile episodes and respiratory symptoms before diagnosis.

Percutaneous drainage and meropenem-based treatment successfully managed the multidrug-resistant infection.

The case emphasizes the need for comprehensive imaging and tailored treatment in complex infections.

Abstract

Subphrenic abscesses are rare, yet clinically significant, and are often associated with intra-abdominal infections. The present case report describes the case of a 77-year-old male patient with an unusual presentation of a subphrenic abscess caused by Proteus mirabilis without typical predisposing factors. The patient experienced a prolonged 2-year course characterized by recurrent febrile episodes and respiratory symptoms. The diagnosis was confirmed through imaging and microbiological culture, with percutaneous drainage and culture-directed antibiotic therapy, including meropenem, leading to successful treatment. The multidrug-resistant nature of the pathogen, coupled with the atypical presentation of the patient, posed significant challenges in both diagnosis and management. The case described herein underscores the importance of comprehensive diagnostic imaging, timely intervention and individualized treatment strategies in managing such complex infections.

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