Tuberculous liver abscess in an immunocompetent patient: a case report

Abstract

 An immunocompetent male patient presented with severe pain in the right upper quadrant and fever ranging from 39 to 40 °C. Initial laboratory findings were nonspecific. Contrast-enhanced abdominal computed tomography revealed a hepatic abscess, for which videolaparoscopic drainage and collection of purulent material were performed. Culture identified Mycobacterium tuberculosis, and the Rapid Molecular Test for Tuberculosis (TRM-TB) was positive, demonstrating rifampicin sensitivity and confirming the diagnosis of hepatic tuberculosis. The patient was started on standard antituberculous therapy, showing progressive clinical improvement and being discharged after 21 days. This case highlights the diagnostic challenge of extrapulmonary tuberculosis in immunocompetent individuals and emphasizes the importance of including this etiology in the differential diagnosis of hepatic abscesses, particularly in endemic regions.