Reviewer ’s report  
Title: Splenic abscesses as a first manifestation of Crohn's disease: a case report  
Version: 1 Date: 05 Jun 2019  
 
Reviewer: JD Coyne  
Reviewer's report:  
This is an interesting case report which is well res earched and well presented. Its primary 
message, that of splenic abscess as a primary manifestation of Crohn's disease is almost hidden 
in the plethora of information. This should be more clearly emphasized. In addition, there is 
some repetition in the Abs tract and the Background. They should be shortened and perhaps the 
differential diagnosis preferred  in the background section could be presented in tabulated form. 
The case presentation is also very lengthy and really should be significantly condensed. For  
example, line 103 is unnecessary as are the sentences beginning on lines 106, 128 and 130. The 
references to current guidelines are not relevant, an everyday account of events and 
developments is not required, but a concise rendition of the relevant  facts  relating to the primary 
message would, in my opinion, be better. Who asked for the TEE?  A similar approach is 
required in the Discussion. It fluctuates from splenic abcess and it's differential diagnosis and 
treatment to an unnecessary summary of Crohn's  disease all of which deflect from the primary 
point of the paper. Focus on the main points of the paper and condense the discussion.  
The use of English, although god, requires minor but significant improvement. Examples include 
but are not confined to;  
Line 104 - lymphadenopathy  
Line 109 - investigations were done  
Line 113 - the patient commenced  
Line 115 - it did not resolve  
Line 116 - Inflammatory markers however remained elevated after ten days and antiobiotics 
were discontinued.  
Line 144 - the patien t was readmitted with persistent fever  
Line 151 - Concurrently, a new  
Line 161 - all of which are consistent with Crohn's disease  
Line 166 - was made.  
Line 170 - or even precede gastrointestinal involvement.  
Line 172 - The patients antituberculous treatment was discontinued and she commenced  
Line 211 - In conclusion, this case documents Crohn's disease as a rare cause of splenic abscess.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn  adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is r ecommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold o r are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do yo u have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests . 
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available unde r an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ).  I understand that any comments 
which I do not wish to be included in my named report can be included  as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
Title: Splenic abscesses as a first manifestation of Crohn's disease: a case report  
Version: 1 Date: 05 Jun 2019  
 
Reviewer: JD Coyne  
Reviewer's report:  
This is an interesting case report which is well res earched and well presented. Its primary 
message, that of splenic abscess as a primary manifestation of Crohn's disease is almost hidden 
in the plethora of information. This should be more clearly emphasized. In addition, there is 
some repetition in the Abs tract and the Background. They should be shortened and perhaps the 
differential diagnosis preferred  in the background section could be presented in tabulated form. 
The case presentation is also very lengthy and really should be significantly condensed. For  
example, line 103 is unnecessary as are the sentences beginning on lines 106, 128 and 130. The 
references to current guidelines are not relevant, an everyday account of events and 
developments is not required, but a concise rendition of the relevant  facts  relating to the primary 
message would, in my opinion, be better. Who asked for the TEE?  A similar approach is 
required in the Discussion. It fluctuates from splenic abcess and it's differential diagnosis and 
treatment to an unnecessary summary of Crohn's  disease all of which deflect from the primary 
point of the paper. Focus on the main points of the paper and condense the discussion.  
The use of English, although god, requires minor but significant improvement. Examples include 
but are not confined to;  
Line 104 - lymphadenopathy  
Line 109 - investigations were done  
Line 113 - the patient commenced  
Line 115 - it did not resolve  
Line 116 - Inflammatory markers however remained elevated after ten days and antiobiotics 
were discontinued.  
Line 144 - the patien t was readmitted with persistent fever  
Line 151 - Concurrently, a new  
Line 161 - all of which are consistent with Crohn's disease  
Line 166 - was made.  
Line 170 - or even precede gastrointestinal involvement.  
Line 172 - The patients antituberculous treatment was discontinued and she commenced  
Line 211 - In conclusion, this case documents Crohn's disease as a rare cause of splenic abscess.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn  adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is r ecommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold o r are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do yo u have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests . 
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available unde r an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ).  I understand that any comments 
which I do not wish to be included in my named report can be included  as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
Title: Splenic abscesses as a first manifestation of Crohn's disease: a case report  
Version: 1 Date: 05 Jun 2019  
 
Reviewer: JD Coyne  
Reviewer's report:  
This is an interesting case report which is well res earched and well presented. Its primary 
message, that of splenic abscess as a primary manifestation of Crohn's disease is almost hidden 
in the plethora of information. This should be more clearly emphasized. In addition, there is 
some repetition in the Abs tract and the Background. They should be shortened and perhaps the 
differential diagnosis preferred  in the background section could be presented in tabulated form. 
The case presentation is also very lengthy and really should be significantly condensed. For  
example, line 103 is unnecessary as are the sentences beginning on lines 106, 128 and 130. The 
references to current guidelines are not relevant, an everyday account of events and 
developments is not required, but a concise rendition of the relevant  facts  relating to the primary 
message would, in my opinion, be better. Who asked for the TEE?  A similar approach is 
required in the Discussion. It fluctuates from splenic abcess and it's differential diagnosis and 
treatment to an unnecessary summary of Crohn's  disease all of which deflect from the primary 
point of the paper. Focus on the main points of the paper and condense the discussion.  
The use of English, although god, requires minor but significant improvement. Examples include 
but are not confined to;  
Line 104 - lymphadenopathy  
Line 109 - investigations were done  
Line 113 - the patient commenced  
Line 115 - it did not resolve  
Line 116 - Inflammatory markers however remained elevated after ten days and antiobiotics 
were discontinued.  
Line 144 - the patien t was readmitted with persistent fever  
Line 151 - Concurrently, a new  
Line 161 - all of which are consistent with Crohn's disease  
Line 166 - was made.  
Line 170 - or even precede gastrointestinal involvement.  
Line 172 - The patients antituberculous treatment was discontinued and she commenced  
Line 211 - In conclusion, this case documents Crohn's disease as a rare cause of splenic abscess.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn  adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is r ecommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financia lly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold o r are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do yo u have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the  above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests . 
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available unde r an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ).  I understand that any comments 
which I do not wish to be included in my named report can be included  as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant