Splénomégalie multi-nodulaire révélatrice d’une tuberculose multifocale à localisation splénique et vertébrale: à propos d’un cas

Splenic tuberculosis and Pott´s disease are two rare entities, in particular in immunocompetent people. We here report the case of a 57-year-old immunocompetent woman presenting with atypical pain in the left hypochondriac region evolving over the last 3 months, associated with lower limb paraparesis with progressive onset. Laboratory data did not provide any specific information regarding diagnosis, except for positive response to the QuantiFERON Test. Abdominal and pelvic computed tomography (CT) scan showed splenomegaly with multiple nodular, hypodense lesions in the spleen. Spinal cord magnetic resonance imaging (MRI) showed spondyldiscitis at the D10/D11 level with epidural and paravertebral collections responsible for medullary compression. GeneXpert assay on bone biopsy was positive and histological examination objectified granuloma characterized by the presence of central caseous necrosis. The diagnosis of multifocal tuberculosis was retained.