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Solitary splenic tuberculosis: A case report.

Hong-Wei Guo¹, Xiu-Qing Liu¹, Yan-Li Cheng²

¹Gastroenterology Department, The First Affiliated Hospital of Tsinghua University, Beijing 100016, China.

World Journal of Clinical Cases

|October 17, 2022

Summary

Solitary splenic tuberculosis (TB) is rare, but this case shows that effective treatment with anti-TB medication can lead to a cure. Surgery may not be necessary for splenic TB.

Keywords:

Anti-tuberculosis medicine Case report Computed tomography Computed tomography-guided spleen biopsy Infectious diseases Pathological diagnosis Solitary splenic tuberculosis

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Area of Science:

Infectious Diseases
Abdominal Imaging
Pathology

Background:

Solitary splenic tuberculosis is an uncommon presentation of Mycobacterium tuberculosis infection.
The optimal management strategy for splenic tuberculosis, particularly regarding surgical intervention, remains debated.
This report focuses on a case without evidence of disseminated extrapulmonary tuberculosis.

Observation:

A 73-year-old male presented with fatigue and weight loss.
Abdominal CT revealed a splenic space-occupying lesion.
A CT-guided splenic biopsy confirmed the diagnosis of splenic tuberculosis.

Findings:

The patient was treated with a standard quadruple anti-tuberculosis regimen.
After one year of treatment, the patient experienced significant clinical improvement, including weight restoration and resolution of fatigue.
Imaging demonstrated a marked reduction in the size of the splenic lesion.

Implications:

Non-surgical management with appropriate anti-tuberculosis therapy can be effective for solitary splenic tuberculosis.
This case suggests that splenic tuberculosis may be curable with medical treatment alone.
Early diagnosis and comprehensive anti-TB treatment are crucial for favorable outcomes.