Splenic tuberculosis in patients with fever of unknown origin

In this study, splenic tuberculosis was reported in five patients with fever of over three weeks duration. In those patients, abdominal ultrasonography and/or abdominal computed tomography revealed multiple hypoechoic and hypodense splenic lesions. The diagnosis required biopsy of cervical lymph nodes in four cases and splenectomy in one. Despite vigorous antituberculous therapy with isoniazid, rifampin and ethambutol; the clinical condition of two of these patients worsened and splenectomy was done. Histological examination of a tissue specimen of the spleen showed multiple caseating granulomas