Laparoscopic intervention in resistant hepatosplenic tuberculosis presenting as pyrexia of unknown origin.

Hepatosplenic tuberculosis (HST), rarely encountered in surgical practice, is seen in-patients with disseminated tuberculosis. A 20-year-old female presenting with pyrexia of unknown origin (PUO) was subsequently diagnosed to have lymph-nodal tuberculosis with involvement of liver and spleen. Despite anti-tuberculosis treatment (ATT) for 3 months, clinical improvement did not occur and fever persisted. Laparoscopic splenectomy and drainage of the hepatic cold abscess were done with favorable results. Smear for acid fast bacilli (AFB), culture for Mycobacterium tuberculosis and histopathological examination (HPE) established the diagnosis of tuberculosis (TB).