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We present a 14-year-old boy, a known case of idiopathic thrombocytopenic purpura (ITP) for five years, and was treated with intermittent oral steroids. He presented with left upper abdominal pain of three months' duration. The pain was dull, aching and non-radiating. There were no other associated features. Before this presentation, he was receiving oral steroids for a month. The patient had been hospitalised in the past for ITP-related bleeding. The patient was managed with anti-tuberculous therapy alone, and after nine months, his splenic abscess regressed significantly in size. Tuberculous splenic abscesses are rare, and in particular, isolated tuberculous splenic abscesses are extremely rare with only three cases reported to date. This may be the first case report of tuberculous splenic abscess in ITP. It is noteworthy that this abscess was minimally symptomatic, with no fever or constitutional symptoms.
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