Abstract: Objective To study clinical diagnosis and treatment of splenic tuberculosis. Methods The clinical data of 18 cases with splenic tuberculosis were retrospectively analyzed.  Results Among 18 patients, fever was found in 14,abdominal pain in 9.The course of fever varied 1 week to 12 months and the mean course is about 2 months. Other common symptoms and signs had abdominal distension in 4, night sweat in 4, anergy in 5,anorexia in 7, splenomegaly in 9. Twelve cases of splenic tuberculosis were confirmed by surgery and pathologic diagnosis,1 case by founding of acid-fast bacillus in gastric juice,5 cases by diagnostic therapy. Of 18 patients, 10 cases had extra-splenic tuberculosis. 9 cases were misdiagnosed before confirmed diagnosis. Among the 18 cases, except 2 dead cases, the others received anti-tuberculosis chemotherapy for more than 1 year, and recovered well.  Conclusion Splenic tuberculosis mainly presents with a long course of fever and abdominal pain, having high rate of misdiagnosis. The diagnosis of splenic tuberculosis mainly relies on pathology and diagnostic therapy, systemic antituberculous therapy and selectivity surgical treatment are the major therapenutic method.

Key words: tuberculosis, splenic, diagnosis, splenectomy