Isolated splenic Mycobacterium tuberculosis complex infection in an immunocompetent individual with FDG-PET positive mass

Tuberculosis, caused by Mycobacterium tuberculosis complex, is a leading cause of mortality in the world, and 15% of the patients may present with extrapulmonary diseases, including splenic lesion. However, isolated splenic infection with M. tuberculosis complex is very rare. A 19-year-old otherwise...

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Published inJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 27; no. 2; pp. 354 - 358
Main Authors Nishina, Sayaka, Sakai, Hitoshi, Kawakami, Toru, Kanai, Shinichiro, Ushiki, Atsuhito, Natori, Tatsuya, Igarashi, Yuriko, Mitarai, Satoshi, Yoshiyama, Takashi, Ishida, Fumihiro, Nakazawa, Hideyuki
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.02.2021
Subjects
Extrapulmonary
FDG-PET
IS6110
Mycobacterium tuberculosis complex
Spleen
Spleen
FDG-PET
IS6110
Mycobacterium tuberculosis complex
Extrapulmonary
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Summary:Tuberculosis, caused by Mycobacterium tuberculosis complex, is a leading cause of mortality in the world, and 15% of the patients may present with extrapulmonary diseases, including splenic lesion. However, isolated splenic infection with M. tuberculosis complex is very rare. A 19-year-old otherwise healthy woman presented with left flank pain, revealing FDG-avid nodules in the spleen. She did not have pulmonary lesions. Histopathology of splenectomized sample showed granuloma, and subsequent PCR revealed amplification of IS6110, a genetic sequence exclusively detected in M. tuberculosis complex. A wide range of differential diagnosis of isolated splenic lesion should include M. tuberculosis infection regardless of pulmonary involvement. An elective splenectomy may be mandatory in timely manner.
ISSN:1341-321X
1437-7780
DOI:10.1016/j.jiac.2020.09.018