[Pancreatic tuberculosis]

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It is currently considered a public health problem due to the socioeconomic conditions of the world population and the increase in other infections such as that due to Human Immunodeficiency Virus (HIV). Pulmonary involvement is the most common form of clinical presentation, although in recent decades extrapulmonary involvement has increased. Among these, digestive disorders represent less than 10%. We present a case of exclusive pancreatic tuberculosis, in the context of an immunocompromised patient. A 43-year-old man with a history of HIV with a low CD4 count and high viral load, without antiretroviral treatment, with one-month history of symptoms characterized by low-grade fever associated with weight loss and nonspecific abdominal pain. An abdominal tomography was performed which showed a collection in the tail of the pancreas; the puncture revealed material with positive culture for M. tuberculosis. Antifimic and antiretroviral treatment was started with a good response. Primary pancreatic tuberculosis is an uncommon extrapulmonary form, given that it is a gland that would be biologically protected by the enzymes it produces. We highlight the rarity of the case and although the prognosis is good with anti-tuberculosis treatment, it could be fatal without correct diagnosis and treatment. The high index of suspicion of pancreatic tuberculosis by the physician and the performance of fine needle aspiration puncture to obtain histopathological evidence are important for a correct diagnosis, especially in HIV patients.