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KMID : 1188320100040010094
Gut and Liver
2010 Volume.4 No. 1 p.94 ~ p.97
Tuberculosis of the Spleen as a Cause of Fever of Unknown Origin and Splenomegaly
Jung Ji-Ye

Kim Yoon-Jae
Kim Hee-Man
Kim Hong-Jeoung
Park Seung-Woo
Song Si-Young
Chung Jae-Bock
Kang Chang-Moo
Pyo Ju-Yeon
Yang Woo-Ick
Bang Seung-Min
Abstract
Background/Aims: 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.
KEYWORD
Splenic tuberculosis, Fever of unknown origin, Splenomegaly
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