Isolated Splenomegaly Revealing Tuberculosis in an Immunocompetent Patient: A Case Report

Research Article

Abstract

Splenic tuberculosis is an extremely rare form of extra pulmonary tuberculosis, usually occurring in immunocompromised patients or as part of systemic dissemination. We report the case of an 18-year-old immunocompetent male presenting with febrile multinodular splenomegaly. The diagnosis was based on radiological findings, positive tuberculin skin test and QuantiFERON assay, and later confirmed by histopathology showing granulomatous lesions with liquefactive necrosis. After an initial six-month anti-tuberculosis regimen, the patient relapsed with fever, erythema nodosum, and recurrent splenic nodules. A multidisciplinary team re-initiated therapy according to WHO guidelines. This case highlights the diagnostic challenges of isolated splenic tuberculosis in immunocompetent individuals, the importance of histopathological confirmation, and the role of treatment duration and adherence in preventing relapse.