Background <p>The spleen is a vital immune organ in the human body that is involved in both cellular and humoral immunity. It has unique physiological functions that contribute to fighting infections, and typically, infections do not lead to the formation of splenic abscesses, making them rare.</p> Case presentation <p>A 49-year-old healthy female presented with high fever, chills, and abdominal pain after tooth extraction. Abdominal enhanced computed tomography (CT) and enhanced magnetic resonance imaging (MRI) confirmed splenic infection and multiple abscesses. <i>Porphyromonas gingivalis</i> was identified by blood culture and next-generation sequencing (NGS). Percutaneous drainage was not used because of the multiple abscesses and high risk of bleeding, and she eventually recovered well with antibiotic treatments.</p> Conclusion <p>We report a case of splenic abscess caused by <i>Porphyromonas gingivalis</i> septicemia. It should be suspected even in healthy adults with high fever and abdominal pain after undergoing oral manipulation.</p>