Isolated Hepatic Tuberculosis in an Adolescent

Abstract

We report a case of a 15-year-old male presenting with persistent epigastric abdominal pain, significant weight loss, lack of appetite, and nausea over a span of 6-7 months. Clinical examination revealed pallor and splenomegaly, while laboratory investigations indicated microcytic anemia and elevated inflammatory markers. Imaging with ultrasound and contrast-enhanced computed tomography (CT) identified multiple ill-defined hypodense lesions in the liver, enlargement of the spleen, and retroperitoneal lymphadenopathy. Despite the absence of pulmonary symptoms and negative results for Acid Fast Bacilli (AFB), a diagnosis of primary hepatic miliary tuberculosis was established based on elevated serum Adenosine Deaminase levels and a positive Mantoux test. Antitubercular therapy was initiated, resulting in significant clinical improvement and normalization of laboratory values within three months. This case underscores the importance of considering extrapulmonary tuberculosis in adolescents with atypical abdominal symptoms, emphasizing the necessity for thorough evaluation and timely intervention to achieve favorable outcomes.