Publication date: May 21, 2025

Tuberculosis is a global health issue affecting millions of people worldwide. While pulmonary tuberculosis is common, hepatic tuberculosis is rare and accounts for less than 1% of cases. Diagnosis is challenging owing to nonspecific symptoms and its ability to mimic other hepatic diseases. This case report describes a 62-year-old male healthcare worker, originally from the Philippines and of Filipino ethnicity, who was initially suspected to have cystic echinococcosis, an epidemiologically uncommon zoonotic disease in both Austria and the Philippines. Echinococcosis was excluded by ultrasound and serology. Several other differential diagnoses, including pyogenic and amoebic liver abscesses, brucellosis, hepatocellular carcinoma, and hepatic metastases of other malignancies, were also ruled out. Ultimately, a biopsy of the liver lesion was performed, and the tissue tested positive for Mycobacterium tuberculosis complex by polymerase chain reaction. The patient was successfully treated with a standard 6-month antitubercular combination therapy. This case highlights the potential for tuberculosis to affect any organ system, including the liver, particularly in patients from high-burden regions.

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