A Case Report of Primary Hepatosplenic Tuberculosis in an Immuno Competent Adult
Published: 2022-07-19
Page: 50-53
Issue: 2022 - Volume 5 [Issue 1]
T. Adioui
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
I. Radouane *
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
S. Ouahid
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
H. Igourman
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
S. Berrag
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
M. Tamzaouerete
Department of Gastroenterology I, Military Hospital, Mohamed V University of Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Primary hepatosplenic tuberculosis is a rare disease, even in endemic areas the diagnosis can be challenging, as it can mimic other infections or neoplastic causes. We describe a rare case of a 50-year-old man with no medical history presented to our unit for exploration of weight loss and chronic abdominal pain. A contrast-enhanced CT scan of the abdomen showed multiple hypodense hepatics and splenic nodules, not enhanced after injection of the contrast; the liver is infiltrated with irregular edges and perfusion disturbances, giving an encephalic appearance. The histological examination of an ultrasound-guided percutaneous liver biopsy showed an epithelio-gigantocellular granuloma without caseating necrosis. However, the PCR test and the Quantiferon-TB Gold test returned positive. The patient was treated with quadruple therapy (ethambutol, rifampicin, isoniazid and pyrazynamide) for two months, then rifampicin and isoniazid for seven months. At the six-month follow-up after stopping treatment, the patient was asymptomatic, and the hepatosplenic lesions had disappeared on a follow-up CT scan.
Conclusion: Hepatosplenic tuberculosis is possible in a suggestive clinical and epidemiological context, even in an immunocompetent adult.
Keywords: Tuberculosis, hepatosplenic, immunocompetent, treatment, follow-up CT scan