Isolated splenic tuberculosis in an immunocompetent child: A case report.

Abstract

Introduction: Tuberculosis remains a major public health problem in developing countries. Isolated splenic tuberculosis is a rare form of extrapulmonary tuberculosis, with few cases documented in the literature, occurring mainly in immunocompromised individuals. The purpose of this article is to contribute to the medical knowledge regarding this rare disease and to highlight the diagnostic challenges and management approach.

Case presentation: A 6-year-old immunocompetent child was admitted with febrile splenomegaly. Initial diagnostic evaluations, including imaging, suggested a possible diagnosis of lymphoma, prompting a laparoscopic splenectomy for diagnostic and therapeutic purposes. Histopathological examination of the splenic tissue revealed features consistent with tuberculosis, despite the absence of a detectable primary focus in the lungs or other organs. Postoperatively, the patient underwent a 6-month course of anti-tubercular therapy, with no recurrence observed during follow-up.

Discussion: Isolated splenic tuberculosis is an uncommon entity, particularly in immunocompetent individuals. The diagnosis is often challenging and delayed due to its nonspecific presentation, which can often mimic other conditions such as lymphoproliferative disorders, metastatic diseases, or other granulomatous diseases. Definitive diagnosis is based on histopathological analysis.

Conclusion: Splenic tuberculosis, though rare in immunocompetent child, should be included in the differential diagnosis list of febrile splenomegaly, particularly in areas where tuberculosis is endemic. Early recognition and appropriate treatment are crucial to prevent complications and ensure favorable outcomes.