Splenic Tuberculosis in an Immunocompetent Young individual: A Rare Case Report
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2015, Vol 3, Issue 3
Abstract
: Splenic tuberculosis per se in an immunocompetent individual is extremely rare. Splenic tuberculosis is occasionally encountered in severely immunocompromised individuals and delays in diagnosis are frequent. It present as pyrexia of unknown origin. Patients all over the world are given antibiotics with necessary laboratory investigations as prophylaxis till the diagnosis is confirmed. When patients do not respond, the possibility of splenic tuberculosis should always be sought. Diagnosis is a challenging task because of non specific symptoms. Patients usually present with low grade fever, weight loss, anaemia and rarely splenomegaly. CT scan is an important investigation which shows hypoechoic lesions suggestive of granuloma. Here is a case of a 28 year old boy who presented with a history of of intermittent low grade fever, pain in left hypochondriac region occurring after vomiting, evening rise of temperature, weakness, loss of appetite, pain in the lower backbone and weight loss for about 3 months. He did not complain cough or any other respiratory complaints. Ultrasonography and computed tomography of abdomen revealed multiple hypoechoic lesions in the spleen. After the diagnosis of splenic tuberculosis, the patient was started on combination of antitubercular drugs under category two of Revised National Tuberculosis Control Programme. He had a favourable response with antitubercular chemotherapy. Follow- up ultrasonography of abdomen after two months of antitubercular therapy showed significant resolution of splenic hypoechoic lesions. We report this case of tuberculosis spleen in an young individual with no signs of immunocompromise. Moreover, we recommend that, splenic tuberculosis should be considered as a diagnostic possibility in patients belonging to endemic areas for tuberculosis, with splenic involvement, especially in those having a past history of tuberculosis or prolong contact of tuberculosis patient, even though the individual is immunocompetent. The case highlights that these type of patients can be diagnosed by non-invasive imaging and managed by medical treatment effectively in a setting with limited resources. Keywords: Splenic tuberculosis, Immunocompetent, Extrapulmonary, Antitubercular.
Authors and Affiliations
Lohit Kumar Kalita, Chayanika Kalita, Ahmed Ali, Umesh Ch. Sarma
Keywords
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