Presentation
Immunocompromised patient with confirmed pulmonary tuberculosis presenting with an acute fever, chest pain and abdominal pain.
Patient Data
Thick-walled, ring-enhancing cystic mass in the right atrioventricular groove with mass effect on the adjacent right ventricle and atrium with an associated, small pericardial effusion.
Multiple, small, low attenuating splenic lesions with multiple, para-aortic lymph nodes.
Bilateral pleural effusions.
Sputum GeneXpert findings confirming pulmonary tuberculosis.
Case Discussion
Splenic microabscess in a patient with confirmed mycobacterium tuberculosis (sputum genexpert) is highly indicative of disseminated abdominal tuberculosis 1.
Pericardial abscesses are a rare complication of chronic pericarditis and usually occur in the right atrioventricular groove as in this case 2. The pathogen has not been isolated, however, with confirmed pulmonary tuberculosis and evidence of abdominal spread, mycobacterium tuberculosis remains the likely cause of the abscess.