Splenic tuberculosis in a patient with ankylosing spondylitis treated with adalimumab

We present a rare case of splenic tuberculosis in a 42-year old man with long-standing ankylosing spondylitis treated with adalimumab. We review the association between antitumor necrosis factor therapy and splenic tuberculosis. Our case, like many other reported cases, illustrates that the index of suspicion of tuberculosis in patients treated with anti TNF therapies must be high and emphasizes that this rare infection may occur even with negative tuberculosis screening before the initiation of therapy.