Tuberculous splenic abscess in a patient with acute myeloblastic leukemia

Chang, M.C.; Lin, S.C.; Jeng, K.S.; Shih, C.C.

Journal of the Formosan Medical Association 84(10): 1173-1179


ISSN/ISBN: 0371-7682
PMID: 3910761
Document Number: 3310
Early detection of splenic abscess is difficult, thereby the mortality rate was very high in the pre-antibiotic era especially in cases of multiple abscesses. Splenic abscess was an unusual association in leukemia until recent fungal splenic abscesses in leukemic patients were reported."' We describe a case of acute myeloblastic leukemia associated with tuberculous abscesses of the spleen which was diagnosed by abdominal echography and echo-guided needle aspiration. A 15-year-old man had a tuberculous verrucosa of the right foot for 7 years without adequate treatment. He ignored the skin lesion until he had acute leukemia. He developed right inguinal lymphadenitis during the remission induction chemotherapy for leukemia, and that appeared to be related to pre-existing tuberculosis of the foot. The initial pathological finding disclosed a suppurative lymphadenitis without a typical picture of tuberculosis or granuloma, therefore he was not treated with full dose of anti-tuberculosis chemotherapy. Thereafter the tuberculous abscesses of the spleen supervened, and associated with tuberculous peritonitis. It was successfully treated by splenectomy, isoniazide, rifampicin, ethambutol, streptomycin and prednisolone. He was followed up for 9 months and was still in complete remission of leukemia.

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Tuberculous splenic abscess in a patient with acute myeloblastic leukemia