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Abstract
Splenic tuberculosis is an unusual clinical phenomenon, especially in immunocompetent
hosts. It often demonstrates diagnostic complexity, which makes the identification
of the agent difficult. We encountered the case of a middle-aged immunocompetent male
who claimed to be suffering from pain in the left hypochondriac region without any
indication of cough, hemoptysis, weight loss or fever. When physically examined, he
had splenomegaly without any other clinical findings. This was further confirmed by
imaging. A splenectomy was performed, and samples were taken for histopathological
examination and microbiological analysis. Gross examination of the specimen showed
multiple nodules coalescing to form a large yellowish-white mass of solid consistency.
Histopathological examination showed large areas of caseation surrounded by multiple
granulomas of epitheloid cells and Langhan's type giant cells throughout the splenic
pulp. PCR verified the diagnosis of Mycobacterium tuberculosis infection. No primary
focus of infection was detected in the lungs or any other organs.