Tuberculosis of the spleen as a cause of Fever of unknown origin and splenomegaly.
OBJECTIVE
Splenic involvement of tuberculosis, which is rare, warrants better definition in the current era of resurgence of tuberculosis.


METHODS
Out of 339 splenectomies performed between January 1989 and December 2008 for indications other than trauma, histopathologic analysis of the spleen revealed tuberculosis in 8 patients.


RESULTS
All eight patients were referred for splenectomy due to fever of unknown origin (FUO). No patient was infected with HIV, and all had at least moderate splenomegaly and hepatomegaly. Three patients had hypersplenism with bleeding manifestations. Radiologic evaluations demonstrated that splenic lesions were present in five patients. Five patients had evidence of tuberculosis manifested as enlarged splenic hilar lymph nodes, cystic lymph nodes, or liver. Two patients exhibited tubercle bacilli in their sputum during the postoperative period.


CONCLUSIONS
In areas where tuberculosis is prevalent, tuberculosis should be considered in the differential diagnosis of patients presenting with FUO and splenomegaly. Extrasplenic involvement is usually seen in splenic tuberculosis, although it may not be apparent at presentation. Splenic tuberculosis can present in isolation without extrasplenic involvement, and even in immunocompetent individuals.
Pottakkat
Biju
B
Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Kumar
Ashok
A
Rastogi
Archana
A
Krishnani
Narendra
N
Kapoor
Vinay K
VK
Saxena
Rajan
R