The presence of abdominal lymphadenopathy associated with symptoms like persistent low-grade fever, weight loss, and decreased appetite suggests the diagnosis of abdominal tuberculosis, especially In the Indian sub-continent. Ultrasound is usually the first modality of investigation in such cases. Lymphadenopathy can be labeled significant if nodes are more than 1cm in diameter ¹. In the present case, acid-fast bacilli could not be demonstrated in the pus drained from the psoas abscess. However, the patient showed good recovery after empirical antitubercular chemotherapy.

Tubercular lymph nodes can be discrete in the beginning. Matted lymph nodes may also be present, especially in long undiagnosed cases. Abdominal tuberculosis patients usually present with ascites, abdominal lymphadenopathy, or psoas abscess. The unique feature of this case was the presence of associated psoas abscess and mild ascites in addition to significant abdominal lymphadenopathy.