Tuberculous abscess of the pancreas.

A patient who presented with a prolonged febrile course was found to have a pancreatic abscess. Routine bacterial cultures of the abscess obtained at laparotomy were negative. The patient was treated with surgical drainage and antibiotics but did poorly. Following a second laparotomy 4 wk later, the tuberculous cause of the pancreatic abscess was recognized. Despite antituberculous therapy, the patient died; autopsy revealed generalized miliary tuberculosis. This case is unique in the accessible literature. We speculate that delayed diagnosis of the tuberculous pancreatic abscess contributed to the final dissemination of tuberculosis in this patient.