Sahoo Satyajeet, Naik Suprava, Mishra Baijayantimala, Durgeshwar Gopal, Panigrahi Manoj Kumar, Bhuniya Sourin
Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar.
Monaldi Arch Chest Dis. 2020 Feb 18;90(1). doi: 10.4081/monaldi.2020.1167.
Tubercular splenic abscess is rare, particularly in immunocompetent patients. Diagnostic difficulties usually arise in patients with tubercular splenic abscess because of its non-specific presentation. We report an elderly male who presented with cough and fever and had pulmonary infiltrates suspicious of tuberculosis. Bronchoalveolar lavage microbiology including XpertMTB/Rif assay was non-contributory. Contrast enhanced computed tomography scan of abdomen revealed multiple non-enhancing lesions in the spleen. Ultrasound guided splenic aspirate revealed pus that was positive for Mycobacterium tuberculosis in XpertMTB/Rif assay confirming the diagnosis of tuberculosis.
结核性脾脓肿较为罕见，尤其是在免疫功能正常的患者中。由于结核性脾脓肿的表现不具有特异性，因此在这类患者中通常会出现诊断困难。我们报告了一名老年男性，他出现咳嗽和发热症状，肺部有疑似肺结核的浸润影。包括XpertMTB/Rif检测在内的支气管肺泡灌洗微生物学检查无诊断价值。腹部增强计算机断层扫描显示脾脏有多个无强化病灶。超声引导下的脾穿刺抽出物为脓液，XpertMTB/Rif检测显示结核分枝杆菌阳性，从而确诊为肺结核。
