A Rare Localization of Tuberculosis: A Case Report and a Review of the Literature

Abstract

The hepatic tuberculosis is rare. The interest of this Knowledge consists in the diagnostic problems particularly in its primitive and macronodular forms. It touches all ages with a peak of frequency during 17 - 50 years old, and a female prevalence. The clinical picture is polymorphous but it is still dominated by the prolonged fever and the alteration of the general state. Case report: 30-year-old female was admitted to our hospital with painless swelling on the right side of chest and feeling of pressure in the right upper quadrant of abdomen. She has no history of fever, weight loss, and night sweating or poor appetite. On clinical examination, the patient was in good general condition. The inflammatory tumefaction of the right chest wall was marked. The palpation of the abdomen revealed a sensitive hepatomegaly. A CT scan revealed a large cystic liver. The laboratory investigations were normal. This appearance was suggestive of a hydatid cyst of the right liver and a surgical management was decided. But the histological study revealed granulomatous inflammation consisting of tuberculoid type granuloma with caseous necrosis. However, abscess of the liver due to MT was highly suspected and anti-tuberculosis therapy was started, the patient responded well. Conclusion: The analysis of this observation and the data of the literature make it possible to retain the rarity; the polymorph expression and not very suggestive of this location.