A Puzzle in the Spleen: A Case Report of Isolated Splenic Tuberculosis

  • W Benhami General Surgery Department, Djilali Rahmouni Public Hospital, Les Orangers, Algiers, Algeria,
  • H Badache General Surgery Department, Mohamed Lamine Debaghine University Hospital Center, Algiers, Algeria,
  • M Brahimi General Surgery Department, Djilali Rahmouni Public Hospital, Les Orangers, Algiers, Algeria,
  • H Guendouz General Surgery Department, Djilali Rahmouni Public Hospital, Les Orangers, Algiers, Algeria,
  • L Rahal General Surgery Department, Djilali Rahmouni Public Hospital, Les Orangers, Algiers, Algeria,
DOI: https://doi.org/10.34118/amr.v4i02.4304
Keywords: Splenic tuberculosis, Cystic spleen, Extrapulmonary TB, Case report

Abstract

Abstract:

Background: Isolated splenic tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic regions. Its cystic presentation can mimic other splenic lesions such as hydatid cysts or abscesses, making diagnosis difficult.

Case Presentation: We present the case of a 53-year-old woman with six months of left upper quadrant pain. Clinical exam revealed a mild splenomegaly. Blood tests showed leukocytosis and elevated ESR. Imaging revealed multiple cystic splenic lesions, the largest measuring 70 × 35 mm, with peripheral enhancement. Chest X-ray and infectious workup were inconclusive. Due to diagnostic uncertainty, a laparoscopy followed by splenectomy was performed. Histopathology revealed caseating granulomas, confirming isolated splenic tuberculosis. The patient received anti-tuberculous treatment and remained well after two years of follow-up.

Conclusion:

This case highlights the diagnostic challenge of cystic splenic tuberculosis and underscores the importance of considering it in the differential diagnosis of atypical splenic lesions, especially in endemic settings.

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Published
2025-07-01
Issue
Vol 4 No 02 (2025)
Section
case report
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