Clinical diagnosis of Tuberculosis with atypical manifestations involving Liver, and spleen with spontaneous subscapular hematoma: A Case Report and Review of Literature

Background Isolated liver and spleen involvement of Tuberculosis (TB) is a rare presentation. Case presentation A 60-year-old male patient from Bahir Dar city in the Amhara region of Ethiopia presented with a four-month history of low-grade fever, significant weight loss, drenching night sweating, poor appetite, exertional shortness of breath, and easy fatigability. Two weeks before his presentation, all the above symptoms worsened, and also started to feel left upper quadrant (LUQ) abdominal pain with a dragging sensation. He had hepatosplenomegaly. Abdominal ultrasound showed hepatosplenomegaly with linear hypoechoic area seen at the upper pole of the spleen, likely infarctions, and also there was a few small periportal Lymphadenopathy. An abdominal CT scan showed a sub-capsular hematoma on the upper pole of the spleen. extrapulmonary tuberculosis (Hepatosplenic TB) was considered and anti-TB medications started. On his 6th month of follow-up and evaluation, his symptoms were improved with normal physical findings and normal investigation findings. Conclusion even though isolated hepatosplenic TB is a rare condition, it has to be considered especially in low socio-economic communities after excluding other alternative diagnoses.