Isolated splenic tuberculosis in an immunocompetent patient

Mandal, S. K.; Ganguly, Jacky; Sil, Koelina; Chatterjee, Sumanta

doi:10.1136/bcr-2013-203271

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…11 However, several recent reports suggest that cures can be achieved with ATT alone without resorting to splenectomy. [4][5][6] In our patient, significant improvement in constitutional symptoms as well as reduction in size of splenic lesion was noted at the first follow-up at 3 months after the start of ATT, indicating therapeutic success of ATT similar to previous observa-tions. [4][5][6] The presence of calcified lesion and other small calcifications on the last sonogram reflects complete healing of the tubercular abscess along with healed granulomas.…”

Section: Discussionsupporting

confidence: 77%

“…Although the abdominal imaging may reveal abnormalities, the confirmation of diagnosis often requires an invasive procedure such USG-or CT-guided aspiration or biopsy of the lesions. 1,5,6 The solid organ lesion on abdominal imaging may mimic lymphoma, fungal or pyogenic abscess, neoplasm, metastases, and rarely sarcoidosis. 2,9 In our patient, the diagnosis was based on cytomorphology of the aspirated material from the splenic lesion and the presence of M. tuberculosis on LPA.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, recent reports indicate the possibility of diagnosis by sonogram or computed tomography (CT)-guided aspiration and achievement of cure with ATT alone. 5,6 Monitoring of splenic lesions in follow-up is usually performed with a sonogram, but long term use of ultrasonography (USG) has rarely been documented. In this report, we describe a child in whom an USG-guided aspiration of splenic abscess lead to a diagnosis of tuberculosis, and periodic ultrasound monitoring showed healing of abscess with ATT alone.…”

Section: Introductionmentioning

confidence: 99%

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Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

Dayal

Williams

Chandrasekaran

et al. 2017

J Pediatr Infect Dis

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Isolated involvement of the spleen is a rare manifestation of childhood tuberculosis. The rare occurrence and presence of nonspecific clinical features often pose diagnostic challenges even in countries where tuberculosis is endemic. Splenectomy is often performed for establishing the diagnosis or achieving a cure in combination with antitubercular therapy (ATT). In this report, we describe a boy who presented with nonspecific symptoms and was detected to have a well-defined lesion in the spleen on ultrasonography. The diagnosis of tubercular splenic abscess was made after line probe assay for the detection of Mycobacterium tuberculosis and cytomorphology of the aspirated material. The tubercular abscess showed complete healing after 9 months of four-drug ATT.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

Dayal

Williams

Chandrasekaran

et al. 2017

J Pediatr Infect Dis

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“…In English, French and German literature dating from 1965 to 1992 just six cases were reported [7]. However, more cases have been reported in recent decades with improving diagnostic modalities" [8,9,10,11,12]. Unlike most most previously reported cases, our patient was immunocompetent and had only a short history of fever.…”

Section: Discussionmentioning

confidence: 61%

A Rare Presentation of Tuberculosis as a Splenic Abscess

Mohan,

Rao,

Rao

et al. 2024

Asian J. Res. Infect. Dis.

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Aims: Splenic tubercular abscess is a very unusual clinical presentation in an immunocompetent host. This rare clinical condition which can occur in two forms. The first form where splenic involvement is seen as a part of miliary Tuberculosis especially in immune-compromised individuals. The second form is the primary involvement of the spleen which is extremely rare. Presentation of the Case: We encountered a case of a middle aged immunocompetent male who presented with vague pain in the left hypochondrium for 3 months duration and fever for 3 days. On clinical examination he had tenderness over the left hypochondrium. On admission he had lymphocytosis with elevated ESR. His Mantoux test was positive. CT scan abdomen revealed multiple hypodensities in spleen,the largest measuring 12x11mm and suspected to be granulomas of Tuberculosis. Laparoscopic splenectomy was done. Histopathological examination showed large areas of caseation surrounded by multiple granulomas of epithelioid and Langerhans type of giant cells suggestive of tuberculosis. No primary focus of tuberculosis was detected in lungs or other organs. Anti-tubercular therapy was started and the patient became afebrile and his general condition improved. Discussion: Splenic involvement was generally thought to be seen only in immunocompromised stages. However, there are sporadic case reports of splenic Tuberculosis in immunocompetent patients such as ours.Where splenic involvement is seen as a part of miliary Tuberculosis especially in immune-compromised individuals, which is less rare, the treatment includes classic antituberculous treatment, and surgical intervention is required as a rare exception . The second form, which is the primary involvement of the spleen, is extremely rare. Early splenectomy followed by oral antituberculous drugs may be considered the more appropriate approach for this entity. Conclusion: Tuberculosis may have protean manifestations and becomes difficult to diagnose when it presents in an uncommon extrapulmonary site. Hence, although primary splenic tuberculosis is extremely rare , it should be also considered among the differential diagnoses of abscesses in the spleen in the regions with high prevalence of Tuberculosis.

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“…Some diagnoses are confirmed by intrasplenic fine-needle aspiration or, in a very small number of cases, by empiric anti-TB therapy. 6 , 7 The patient in this case report had no underlying diseases, usage of any immunosuppressive agents, or any other clinical manifestations indicative of TB, such as low-grade fever, weight loss, or abdominal pain. Due to multiple intrasplenic masses found by an abdominal ultrasound and CT scan, the preoperative impression was splenic angioma.…”

Section: Discussionmentioning

confidence: 91%

Systemic spread of tuberculosis after surgery for a splenic tuberculous abscess without postoperational antituberculosis treatment: a case report

Dong¹,

Zhong²,

Li³

2015

TCRM

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Solitary splenic tuberculosis (TB) is rare, with less than ten cases ever being reported. The diagnosis is established by the pathological analysis of a biopsy from a surgical operation or from a fine-needle aspiration sample. Manifestations of splenic TB include low-grade fever, weight loss, abdominal pain, and diarrhea. This case, however, has no obvious symptoms, and multiple splenic tubercles were discovered during a routine physical examination. Splenic abscesses from TB were diagnosed after the operation. Postoperative spread of TB lead to cerebral tuberculous abscesses and pulmonary TB. Resolution was achieved with anti-TB therapy.

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Isolated splenic tuberculosis in an immunocompetent patient

Cited by 6 publications

References 5 publications

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

A Rare Presentation of Tuberculosis as a Splenic Abscess

Systemic spread of tuberculosis after surgery for a splenic tuberculous abscess without postoperational antituberculosis treatment: a case report

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Isolated splenic tuberculosis in an immunocompetent patient

Cited by 6 publications

References 5 publications

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

A Rare Presentation of Tuberculosis as a Splenic Abscess

Systemic spread of tuberculosis after surgery for a splenic tuberculous abscess without postoperational antituberculosis treatment: a&nbsp;case report

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Systemic spread of tuberculosis after surgery for a splenic tuberculous abscess without postoperational antituberculosis treatment: a case report