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A young male presented with fever and right hypochondrium pain lasting for 1 week. He was tender in the right hypochondrium. Rest of the examination was insignificant. He had a raised ESR of 70mm/1st hour. His abdominal ultrasound
revealed a hypodense lesion in caudate lobe of liver. A Computed tomography scan of the abdomen showed a cystic lesion in caudate lobe of liver suggestive of hydatid cyst. Since echinococcal serology and history of contact with cattle and dogs were negative, he was shifted to surgical unit, where the cyst was excised and sent for histopathology. The biopsy report showed granulomata consisting of epithelioid cells, admixed with lymphoid cells. Langerhan giant cells were seen associated with caseous necrosis suggestive of chronic granulomatous inflammatory process most consistent with tuberculosis. Ziehl Neelsen staining was positive for acid fast bacilli. Isolated Liver Tuberculosis (ILT) is a rare form of tuberculosis. We hereby report a case of ILT that presented with features mimicking hydatid cyst disease.
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