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      TUBERCULOSIS OF SPLEEN PRESENTING WITH PYREXIA OF UNKNOWN ORIGIN IN A NON-IMMUNOCOMPROMISED WOMAN

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          Abstract

          Splenic lesions due to tuberculosis are extremely rare in immunocompetent indi-viduals and delays in diagnosis are frequent. Here, we describe a 49-year-woman presenting with pyrexia-of-unknown origin with no evidence of any immunodefi-ciency. Computed tomography of the abdomen showed an enlarged spleen having multiple small focal hypodense lesions; the later were confirmed to be of tubercu-lous etiology on histopathological examination. She had favorable response with anti-tubercular chemotherapy. We report this case of tuberculosis spleen in an im-munocompetent individual for its rarity and to highlight the fact that these patients can be managed by medical treatment effectively.

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          Primary lymphoma of the spleen. Clinical features and outcome after splenectomy.

          J. Kehoe, Laura Straus (1988)
          A retrospective review was made of patients with primary splenic non-Hodgkin's lymphoma (PSL) diagnosed at surgery at Memorial Hospital between 1970 and 1981. Four patients had splenic involvement only (Group I), three patients had splenic and splenic hilar nodal involvement (Group II), and 14 had involvement of the spleen and other sites including liver (11 patients), bone marrow (eight patients), and distant abdominal lymph nodes (five patients) (Group III). Three of the seven Group I and II patients are alive without disease at 24, 42, and 144 months. There was a trend toward a longer survival for the Group I and II patients as compared with the Group III patients. Patients with truely localized PSL seem to have the same outlook as other Stage I non-Hodgkin's lymphoma patients.
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            Computed tomography of focal splenic lesions in patients presenting with fever.

            Z Y Joazlina, M. Wastie, N Ariffin (2005)
            There is an awareness of the increased incidence of splenic abscess in Southeast Asia giving rise to unexplained fever. This study looks at the role of computed tomography (CT) in evaluating focal splenic lesions in patients presenting with fever. 37 patients presenting with fever of unknown origin underwent CT and this study retrospectively analyses the findings in these patients. 13 patients also had associated abdominal pain. Patients with conditions at high risk for splenic infection include: diabetes mellitus in ten patients, leukaemia in seven patients, human immunodeficiency virus infection in five patients, intravenous drug abuse in six patients, and steroid therapy in two patients. No risk factors could be identified in seven patients. Splenic abscess was diagnosed in 28 patients. A range of infecting organisms was isolated but the most frequent were Staphylococcus aureus (eight), tuberculosis (four), Streptococcus (four), fungal (four) and melioidosis (four). No infecting organism could be identified in ten cases though in patients with leukaemia with multiple low attenuation areas, the cause was presumed to be fungal. Six patients were diagnosed to have splenic infarcts though differentiation from splenic abscess could be difficult; these patients were treated for an abscess and all had endocarditis. Three patients were subsequently diagnosed with lymphoma. Percutaneous abscess drainage was performed in five patients and splenectomy was carried out in six patients. CT proved to be very useful as it not only revealed the size and extent of any splenic abnormality but it assisted with guidance for percutaneous drainage, determined the site for biopsy, and provided follow-up after treatment.
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              Hepatosplenic tuberculosis mimicking disseminated candidiasis in patients with acute leukemia.

              J. Choi, D. Kim, P C Min … (2000)
              Two cases of hepatosplenic tuberculosis in patients with acute leukemia during or after chemotherapy following prolonged neutropenia are presented. Tuberculosis should be considered as one cause of hepatosplenic abscesses during prolonged neutropenia, especially in countries where the disease is endemic.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Lung India
                Journal ID (publisher-id): LI
                Title: Lung India : Official Organ of Indian Chest Society
                Publisher: Medknow Publications (India )
                ISSN (Print): 0970-2113
                ISSN (Electronic): 0974-598X
                Publication date (Print): Jan-Mar 2008
                Volume: 25
                Issue: 1
                Pages: 22-24
                Affiliations
                [1 ]Department of Respiratory Medicine, Postgraduate Institute of Medical Sciences, Rohtak., India
                [2 ]Department of Physiology, Postgraduate Institute of Medical Sciences, Rohtak., India
                [3 ]Department of Pathology, Postgraduate Institute of Medical Sciences, Rohtak., India
                Author notes
                Correspondence: Dr. Prem Parkash Gupta, Professor, Department of Respiratory Medicine, 9J/17, Medical Enclave, PGIMS, Rohtak, India, Pin 124001 Email: gparkas@ 123456yahoo.co.in
                Article
                Publisher ID: LI-25-22
                DOI: 10.4103/0970-2113.44134
                PMC ID: 2853043
                PubMed ID: 20396657
                SO-VID: eaaf89bc-d44c-412f-a91b-89224277e651
                Copyright © © Lung India
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : February 2007
                Date accepted : March 2007
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Respiratory medicine
                Keywords: splenic tuberculosis,non-immunocompromised patient,ct guided splenic biopsy
                Data availability:
                ScienceOpen disciplines: Respiratory medicine
                Keywords: splenic tuberculosis, non-immunocompromised patient, ct guided splenic biopsy

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