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Isolated Splenic Cold Abscesses with Perisplenic Extension: Treated Successfully without Splenectomy
Mohan Khadka1,2, Ravi Pradhan2
1ADK Hospital, Malé, Maldives.
Case Reports in Gastrointestinal Medicine
|September 16, 2017
Summary
Splenic tuberculosis, a rare condition in immunocompetent individuals, presents diagnostic challenges. This case highlights successful treatment of splenic cold abscesses caused by Mycobacterium tuberculosis with antitubercular therapy.
Area of Science:
- Infectious Diseases
- Microbiology
- Radiology
Background:
- Splenic tuberculosis (TB) is uncommon, particularly in immunocompetent hosts, often presenting with complex diagnostic features.
- Multiple splenic cold abscesses with perisplenic extensions represent a rare manifestation of TB.
Observation:
- An immunocompetent adult male presented with fever, left lower chest pain, anorexia, and weight loss.
- Physical examination revealed left lower infra-axillary tenderness and Traube's space dullness, with no palpable spleen.
Findings:
- Ultrasound-guided aspiration of splenic abscess fluid confirmed Mycobacterium tuberculosis (MTB) via polymerase chain reaction (PCR).
- No primary pulmonary or extrapulmonary TB focus was identified.
Implications:
- This case underscores the importance of considering splenic TB in the differential diagnosis of unexplained abdominal symptoms and weight loss, even in immunocompetent patients.
- Early diagnosis and appropriate antitubercular therapy (ATT) are crucial for successful management of splenic TB.
