Radiological manifestations of splenic tuberculosis: A 23-patient case series from India

S. K. Sharma, Duncan Smith-Rohrberg, Mohammad Tahir, Alladi Mohan, Ashu Seith

Research output: Contribution to journalReview articlepeer-review

57 Scopus citations

Abstract

Background & objectives: Splenic tuberculosis (TB) is a less common but important manifestation of abdominal TB, especially in India and other developing countries. Its prevalence is increasing with the epidemic of HIV-TB co-infection and subsequent rise in extrapulmonary TB. The range of radiological manifestations of splenic TB is poorly described. Here, we review the ultrasonographic and computed tomographic (CT) images of 23 cases from two large tertiary care centers in India. Methods: Radiographic images, ultrasonographic in all cases and CT in selected cases, were retrospectively analyzed in a series of 23 patients presenting to two large tertiary care centers in India, with suspected TB and with splenomegaly on physical examination. Images were assessed at baseline and when available following anti-tuberculosis therapy. Results: The ultrasound and CT findings included, in order of most common: single or multiple hypoechoic focal lesions, splenic abscess, calcifications (on CT), and isolated splenomegaly. Five of the six patients with findings of isolated splenomegaly on ultrasound were found to have lesions on CT. Interpretation & conclusion: Ultrasonography of the spleen is an affordable, non-invasive imaging modality, which can be helpful in diagnosis of splenic TB and assessment of therapeutic response. Proper use of this imaging modality in splenic TB should help avoid unnecessary CT imaging or invasive procedures. However, this technique is operator-dependent, and, when extensive intra-abdominal involvement is suspected, or the diagnosis is unclear, CT may be necessary.

Original languageEnglish
Pages (from-to)669-678
Number of pages10
JournalIndian Journal of Medical Research
Volume125
Issue number5
StatePublished - May 2007
Externally publishedYes

Keywords

  • Abdominal computerized tomography
  • Abdominal ultrasound
  • Disseminated tuberculosis
  • Extrapulmonary tuberculosis
  • HIV
  • Splenomegaly
  • Tuberculosis

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