Abstract
IntroductionIsolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality.Case presentationA 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably.ConclusionThis report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.
Highlights
Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis
This report emphasizes the fact that, a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions
Another advantage is that polymerase chain reaction (PCR) analysis can distinguish M. tuberculosis from other mycobacterium saving a lot of precious time
Summary
Though hepatic tuberculosis is not a rare disease entity, tubercular liver abscess (TLA) is extremely rare even in a country where tuberculosis is an alarming public health problem. The patient was undergoing follow-up for a liver abscess (right lobe) which was diagnosed previously as an amoebic liver abscess (ALA) based on a positive amoebic serology report from a private laboratory He was treated conservatively for this and discharged 3 months before this present episode. An ultrasonogram (USG) of the abdomen on the same day revealed a 5.6 × 6.8 × 8.8 cm illdefined, heterogeneous hypo-echoic lesion reaching up to the liver surface with cystic areas in the right lobe of the liver suggestive of an abscess (Figure 1). His liver was enlarged with a span of 16.6 cm with no other focal lesion.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
