Extra Pulmonary Tuberculosis Manifesting as Liver Abscess

Liver abscess is a rare presentation of extrapulmonary tuberculosis. It may present with nonspecific symptoms such as fever, weight loss and abdominal pain and requires a high degree of suspicion. We present a case of a 57-year-old male previously treated for a liver abscess and presented with abdominal pain, vomiting and fever and a contrast-enhanced computed tomography (CECT) showed a loculated liver abscess. Ultrasound-guided aspiration of the pus was sent for GeneXpert MTB (Cepheid, Sunnyvale, CA, USA) and mycobacterial culture which confirmed the diagnosis. The patient was started on anti-tubercular therapy and clinically improved.