Abstract
In Bangladesh tuberculosis (TB) cases are fairly common but isolated hepatobilliary TB cases are extremely rare. Liver abscess due to TB without involvement of any other site causes diagnostic delay and can easily confuse with pyogenic or amoebic liver abscess or haepatocellular carcinoma. We present a case of a 44-years-old diabetic,normotensive male who presented with prolonged high grade fever with chill and rigor with tender hepatomegally. He was put on treatment for liver abscess but was not responding. Later on, histopathology was done and it turned out to be a case of tuberculous liver abscess.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.155-157
Highlights
TB can virtually involve any organ of the body but hepatic involvement is rare
Other than tuberculous liver abscess, different forms of hepatobilliary TB has been reported like primary hepatic TB4,5, tuberculous hepatitis[6,7], tuberculous cholangitis and TB of the bile duct[8]
The objective of this study is to emphasize on the fact that, tuberculous abscess should always be ruled out in a patient with non resolving liver abscess or unexplained hepatic space occupying lesion (SOL) that may confer early treatment and better outcome
Summary
TB can virtually involve any organ of the body but hepatic involvement is rare. Case summary A 44-years-old newly detected type 2 diabetic male got himself admitted with fever, weight loss and severe anorexia for 2 months His fever was high grade, continued, associated with chill and rigor and drenching sweat, more marked at evening, highest recorded temperature was 1060F and lowest was 1010F. On the day of admission, examination revealed 1020F temperature, tender hepatomegaly that was 4 cm from right costal margin along right mid-clavicular line On admission his random blood sugar was 14.1 mmol/l, there was neutrophillic (83%) leucocytosis (19,500/mm3) with thrombocytosis (6, 50,000/mm3), ESR was 7mm in first hour, chest X-ray and liver function tests were normal. Ultrasonography (USG) showed solitary liver abscess (70mm × 62mm) He was put on injectable ciprofloxacin (500 mg bid) and metronidazole (500 mg tds) and soluble insulin (total 26 units of Actrapid 40 U/ml) and apparently he was improving. We couldn’t present the histopathology slide in here due to technical shortcomings
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