Isolated hepatic tuberculous abscess in a renal transplant recipient

Abstract

Tuberculous liver abscess is rare worldwide. We report a 26-year-old renal transplant recipient who presented with fever, fatigue, and weight loss. Ultrasound (US) of the abdomen showed a cystic mass of 7 X 6 cm in the subcapsular region of right liver lobe. US-guided percutaneous drainage was performed and 100 mL of yellow-colored pus was aspirated. The patient was empirically started on ampicillin sulbactam treatment. Despite this treatment, the symptoms persisted. Subsequent control abdominal US showed the persistence of a cystic mass of 7 X 6 cm with thin septation in the subcapsular region near the right liver lobe, which were subsequently diagnosed as a focal hepatic tuberculous abscess by positive culture in Lowenstein-Jensen medium. He was concomitantly started on systemic antituberculous therapy. A tuberculous liver abscess must be considered in the differential diagnosis. Percutaneous drainage along with systemic antituberculous chemotherapy must be considered as an alternative to surgery for the management. A greater awareness of this clinical entity is required for successful treatment.