A RARE CASE OF MASSIVE SPLENOMEGALY IN AN IMMUNOCOMPETENT ADULT: AN UNUSUAL MANIFESTATION OF TUBERCULOSIS

Background: Tuberculosis (TB) remains a global health challenge with diverse clinical manifestations. While pulmonary TB is the most recognized form, extrapulmonary TB, particularly involving solid organs like the spleen, is less common and often overlooked in immunocompetent individuals. We report a rare case of massive splenomegaly in a 38-year-old immunoc Case Presentation: ompetent female without any prior comorbidities, presenting with intermittent fever, signicant weight loss, and a palpable spleen extending to the umbilicus. Despite extensive diagnostic evaluations, typical infectious etiologies were ruled out, and initial tests for TB were inconclusive. Imaging studies, including contrast-enhanced computed tomography (CECT) of the thorax and abdomen, revealed patterns suggestive of disseminated TB, prompting a trial of anti-tubercular therapy. The patient showed signicant clinical improvement with reduced spleen size and resolution of symptoms following treatment. This case underscores the importance of considering tuberculosis in t Conclusion: he differential diagnosis of massive splenomegaly, even in immunocompetent patients, and highlights the challenges of diagnosing extrapulmonary TB. Early consideration and appropriate management can lead to favorable outcomes, stressing the need for heightened awareness among clinicians regarding atypical presentations of TB.