Background: Liver abscesses in thalassemics are predominantly pyogenic.
Case characteristics: 12-year-old thalassemic boy with abdominal pain and high grade fever for 15 days.
Observation: CT abdomen revealed multiple liver abscesses. Pus culture and sensitivity showed multidrug-resistant mycobacteria. Patient was started on second line anti-tubercular drugs.
Outcome: He responded well with symptomatic improvement and is doing well after 6 months of follow-up.
Message: Liver abscess in patients with thalassemia rarely can be tubercular.