Abstract
Introduction
Splenic tuberculosis (ST) is an uncommon entity, especially in an immunocompetent patient. Therefore, diagnosis delays may be seen and can lead to fatal complications.
Presentation of case
We report a 37-year-old female with no medical history who presented to the emergency with a spontaneous left pyo pneumothorax. Reverse transcription-PCR analysis of COVID-19 was positive. Chest and abdominal Computed Tomography showed a ruptured splenic abscess with left pyopneumothorax. The diagnosis of splenic abscess with pleural fistulization was strongly suspected. Emergency surgery was decided for both therapeutic and diagnostic purposes. A left video thoracoscopy and splenectomy was performed. After histopathological examination, the diagnosis of ST ruptured in the pleural cavity was confirmed. The patient had a stable recovery and completed a 9-months regimen of anti-tuberculosis medications.
Discussion
ST has no characteristic symptoms and diagnosis may be delayed until life-threatening complications arise. Pyopneumoyhorax complicating ST is an exceptional evolution and rarely reported in the literature. In this case, the authors reported a ST discovered following respiratory signs related to an intrapleural splenic rupture in a young woman co-infection with COVID-19.
Conclusion
ST is extremely rare and has no characteristic symptoms. The evolution is unpredictable and can lead to splenic rupture. This rupture can be intrathoracic making the diagnosis more difficult.
【저자키워드】 Tuberculosis, Computed tomography, CTComputed Tomography, STSplenic tuberculosis, Splenic tuberculosis, TBTuberculosis, 【초록키워드】 COVID-19, Evolution, diagnostic, Diagnosis, Symptom, medications, Symptoms, therapeutic, female, Patient, Co-infection, Complication, complications, characteristic, Analysis, Emergency surgery, regimen, life-threatening, positive, rupture, presentation, reported, was performed, histopathological, exceptional, intrapleural, more difficult, Splenic, splenic abscess, with COVID-19, 【제목키워드】 COVID-19, Case report,