Isolated primary tubercular splenic abscess: a case report

Splenic abscess is a rare condition, with tubercular splenic abscess being even rarer and associated with high mortality if untreated. This case report describes a young male presenting with a 3-month history of intermittent fever, left upper abdominal pain, and generalized weakness. After detailed clinical and radiological examination ultrasonography (USG) - guided pigtail catheter drainage was performed, and pus analysis revealed elevated adenosine deaminase (ADA) levels (322 IU/) and acid-fast bacillus (AFB) positivity. The patient showed significant clinical improvement within 10 days after ATT initiation. This case highlights the rarity of primary tubercular splenic abscess in immunocompetent individuals and underscores the efficacy of minimally invasive drainage combined with anti-tubercular therapy as an alternative to splenectomy. Tuberculosis should be considered in the differential diagnosis of splenic abscess, and a thorough diagnostic workup is essential for optimal management.