title: Multidrug-resistant tuberculosis presenting as a solitary splenic mass in an immunocompetent patient.
abstract: Here, we report a case of multidrug-resistant tuberculosis (TB) presenting as a solitary splenic mass in a 60-year-old immunocompetent patient. Splenic TB is unusual and, when present, is usually associated with disseminated disease in immunocompromised patients. A high level of suspicion is required for diagnosis, and, as occurred in our case, it may be an unexpected finding following surgery. Diagnosis was made by polymerase chain reaction, which showed the presence of Mycobacterium tuberculosis DNA. Interestingly, rifampicin- and isoniazid-resistant genes were detected in our analysis. Splenic TB diagnosis and treatment are reviewed.
authors.affiliation: Department of Clinical Microbiology, Clinica Universidad de Navarra, Avenida Pio XII no. 36 (31008), Pamplona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rojo
authors.forename: Maria A
authors.initials: MA
authors.lastname: Ibáñez
authors.forename: Carla A
authors.initials: CA
authors.lastname: Alonso
authors.forename: Maria E
authors.initials: ME
authors.lastname: Portillo
authors.forename: Javier
authors.initials: J
authors.lastname: Quintana
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Yuste
authors.forename: Jose L
authors.initials: JL
authors.lastname: Del Pozo
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D002374:Catalase / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008875:Middle Aged; D020125:Mutation, Missense; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification*; D010088:Oxidoreductases / Q000235:genetics; D016133:Polymerase Chain Reaction; D049268:Positron-Emission Tomography; D011860:Radiography, Abdominal; D013163:Splenomegaly / Q000382:microbiology* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D010088:Oxidoreductases; D002374:Catalase; C480353:katG protein, Mycobacterium tuberculosis; C085257:InhA protein, Mycobacterium; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit