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Splenic tuberculosis (TB) in the form of multiple splenic cold abscesses with perisplenic extensions is a rare disease, especially in an immunocompetent host. It demonstrates diagnostic complexity, which makes identification of the disease difficult. We report a case of an immunocompetent adult male who presented with fever, pain in the left lower chest, decreased appetite, and significant weight loss. On physical examination, he had tenderness in the left lower infra-axillary region and Traube's space dullness without palpable spleen. Ultrasound-guided aspiration of the abscess fluid revealed  Mycobacterium tuberculosis  (MTB) by polymerase chain reaction (PCR). No primary focus of the infection was detected in the lungs or any other organs. The patient was successfully treated with antitubercular therapy (ATT).

Isolated Splenic Cold Abscesses with Perisplenic Extension: Treated Successfully without Splenectomy