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Isolated Splenic Tuberculosis without Any Radiological Focal Lesion
Sunil Raviraj1, A Gogia1, A Kakar1
1Department of Medicine, Ganga Ram Institute of Postgraduate Medical Education and Research Center (GRIPMER), Sir Ganga Ram Hospital, New Delhi 110060, India.
Isolated splenic tuberculosis is a rare condition, particularly in immunocompetent individuals. This case highlights diagnosis via splenic biopsy and successful treatment with anti-tubercular therapy.
Area of Science:
- Infectious Diseases
- Pathology
Background:
- Tuberculosis (TB) of the spleen is rare.
- Isolated splenic TB is unusual, especially in immunocompetent patients.
Purpose of the Study:
- To report a rare case of isolated splenic tuberculosis in an immunocompetent adult.
- To emphasize diagnostic challenges and management of splenic TB.
Main Methods:
- Clinical presentation of a 63-year-old male with fever, weight loss, and splenomegaly.
- Diagnostic workup including imaging (ultrasound, CT), blood tests (pancytopenia, elevated ESR, Mantoux test), and exclusion of other conditions.
- Histopathological examination of splenic biopsy revealing caseation, epithelioid granulomas, and Langerhans cells, with positive acid-fast bacilli (AFB) gene probe.
Main Results:
- The patient presented with non-specific symptoms and splenomegaly.
- Initial investigations and bone marrow biopsy were inconclusive.
- Splenic biopsy confirmed tuberculosis (TB) with positive AFB, despite no evident primary focus in lungs or other organs.
Conclusions:
- Splenic biopsy is crucial for diagnosing rare cases of isolated splenic tuberculosis.
- Prompt antitubercular treatment led to clinical improvement in this immunocompetent patient.
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