Epidemiological Features, Etiopathogenesis, Diagnostic Evaluation, and Management Protocol of Splenic Tuberculosis: A Systematic Review

Introduction: The splenic tuberculous involvement is common than other intra-abdominal solid organs such as the liver, pancreas, and kidney. The aim of this article is to present and share a review of the English-language literature on splenic tuberculosis (TB) to gain a better understanding of etiopathogenesis, epidemiological features, and diagnostic methods and provide guidelines for its management and to present our experience of six cases. Methods: The systematic search of the literature was performed on PubMed and Medline from 1950 to 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Fifty-two manuscripts were included in this systematic review. All resulting titles, abstract, and full text, whenever available, were read and kept for reference. Conclusion: Direct histopathological demonstration is the best diagnostic modality. Fine-needle aspiration cytology is the study of choice and polymerase chain reaction assay increases its sensitivity. The standard short course antitubercular therapy for 6 months is recommended for isolated splenic TB, and for widespread disease, 12-month therapy is recommended. Surgery is reserved for failure of medical therapy and complications such as abscess formation.