Splenic tuberculosis presenting as hypersplenism

SummaryA 9-year-old girl with a 5–6-month history of abdominal distension and fever was found to have massive splenomegaly with features of hypersplenism. Apart from a strongly positive Mantoux test, all investigatons for massive splenomegaly proved negative. Splenectomy was carried out and histopathological examination of the spleen revealed granulomatous lesions suggestive of tuberculosis. The child improved after splenectomy and anti-tuberculous therapy and is doing well on follow-up. Splenic tuberculosis should be considered as an unusual cause of massive splenomegaly and hypersplenism.