Isolated Tubercular Liver Abscess In Pediatric Age Group

Abstract

We report about two patients, the first 7 years and the second 10 years old presenting in our outpatient clinic with history of pain in right upper abdomen, high fever, anorexia and weight loss. A detailed search failed to identify any other focus of tubercular infection. Laparotomy was carried out in the first patient as the abscess was multiloculated and inaccessible to percutaneous aspiration. Antitubercular therapy was begun in the postoperative period when high fever persisted and polymerase chain reaction came out positive for Mycobacterium Tuberculosis. In the second patient diagnosis was made by enzyme linked immunosorbant assay but surgical drainage was done because percutaneous aspiration failed to drain the multiloculated abscess. Both the patients showed dramatic response with antitubercular therapy and gradually hepatomegaly regressed. Isolated hepatic tubercular liver abscess, though a very rare diagnosis should always be considered when signs and symptoms fail to improve with antiamoebic, antibacterial therapy and conventional surgical management.