BMJ Case Reports 2018; doi:10.1136/bcr-2018-224613
  • Unusual presentation of more common disease/injury

Splenic cyst and its management in a 21-month-old boy: a rare complication of invasive meningococcal disease

  1. Nigel W Crawford1,2,4
  1. 1Department of General Medicine, Royal Children’s Hospital (RCH), Melbourne, Victoria, Australia
  2. 2Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  3. 3Department of Radiology, Royal Children’s Hospital (RCH), Melbourne, Victoria, Australia
  4. 4Surveillance of Adverse Events Following Vaccination In theCommunity (SAEFVIC), Murdoch Children’s Research Institute (MCRI), Melbourne, Victoria, Australia
  1. Correspondence to Dr Jeremy John Pratt, jeremyjpratt{at}
  • Accepted 17 April 2018
  • Published 4 May 2018


Splenic complications of invasive meningococcal disease (IMD) are well recognised, though cyst formation is rare, particularly in paediatric populations. The best approach to their management is not yet established. This case outlines the management of a splenic cyst in a 21-month-old boy following severe IMD. The case took place in the context of an acute emergence of serogroup W prompting significant media attention and subsequent change in vaccination practice at a jurisdictional level in Australia. The patient was critically unwell early in the illness, then later a collection in the left upper quadrant was detected, shown on ultrasound to be a 11.6×7.7 cm splenic cyst. In this case, the cyst was managed by ultrasound-guided drainage tube insertion. The residual collection was small and stable on subsequent imaging.


  • Contributors All authors provided meaningful contributions to this case report. First drafts were provided by JJP. Specialist input was sought from both TGC and EB. NWC provided overall supervision of the case report. All authors contributed to developing, editing and refining the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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