Disseminated Tuberculosis Presenting with Hepatosplenomegaly and Ascites
Fakrul Ahsan1, Md. Khairul Hassan Jessy2, Md. Shahedur Rahman Khan2,Mohammed Kamrul Hasan3, AHM Raihanuzzaman Sarkar4, ASM Fateh Akram4
Abstract
Disseminated tuberculosis is notoriously known to be a great mimicker of other diseases. It is an
important differential diagnosis for fever of unknown origin (FUO) and it can present with
hepatosplenomegaly,ascites,lymphadenopathy and may have meningitis and with hematological
abnormalities including pancytopenia or a leukemoid reaction. It is unusual among immune competent
individuals. Herein, we report a case of 55 years old man who presented with fever, dry cough,weight
loss, mild hepatosplenomegaly with moderate ascites. Ascitic fluid study showed increased adenosine
deaminase(ADA), sputum AFB smears were negative. Patient was successfully treated with antituberculous
therapy with oral steroid.
Keywords: Disseminated tuberculosis, hepatosplenomegaly, ascites.
Abbreviations: ADA: Adenosine Deaminase, ALT: Alanine Transaminase, ATT: Anti Tubercular Therapy,
INH: Isoniazid, RIF: Rifampicin, PZA: Pyrazinamide, EMB: Ethambutol.