An unusual presentation of tuberculosis as splenic and hepatic abscesses.

Tuberculosis still remains a major health problem in India, with varying clinical presentations and involvement of different organs/systems. We encountered a 42 year old male patient presenting with persistent weight loss when he was diagnosed as having Type 2 DM. Upon performing a CECT abdomen, he was found to have multiple hypodense splenic abscesses and hepatic cysts with septations. USG guided aspiration of perisplenic fluid collection demonstrated Acid Fast Bacilli with Auramine and Ziehl – Neelson stains and patient was put on ATT. This finding in an otherwise immunocompetent person, puts forward the involvement of Spleen and Liver in Disseminated Koch’s, showcasing the remarkable heterogeneity of presentation of TB.