Abstract
Peritoneal tuberculosis (TbP), an uncommon peritoneal infection, is commonly diagnosed in immigrants from developing countries and represents a substantial proportion of cases of extra pulmonary tuberculosis. The variability in patient presentation and the indolent nature of the infection, combined with limited diagnostic strategies available for TbP, often results in delayed diagnosis. Case: Described herein is the case of a 39 years old male recent immigrant from Mali (West Africa), with no significant medical history that presented to hospital with a four-day history of abdominal pain and swelling. Examination was significant for distended abdomen and shifting dullness. No signs and symptoms suggested pulmonary infection, however, QuantiFERON-TB Gold and purified protein derivative (PPD) test were positive suggesting latent Tb infection. In the absence of pulmonary tuberculosis, a diagnosis of TbP should be established histologically. Laparoscopic biopsy showed granuloma but the typical caseating granuloma of TbP was not seen. Nonetheless, based on the extent of the clinical and laboratory findings, the patient was diagnosed with TbP and anti Tb treatment ensued with successful outcome. Conclusion: The lack of caseating granulomas in the pathology should not rule out a diagnosis of TbP, especially in cases where accompanying evidence suggests some form of Tuberculosis.
Highlights
Tuberculosis (Tb) infection caused by mycobacterium tuberculosis or other mycobacterium species is a major communicable disease worldwide
Primary Tb infection occurs in the lung, the portal through which infection spreads to other sites such as the kidney, spine, genitals and the peritoneum [1]
Whereas a histological finding of caseating granuloma is considered required for definitive diagnosis of Peritoneal tuberculosis TSH (TbP), the literature documents the occurrence of non-caseating granulomas in peritoneal Tb [5]
Summary
Tuberculosis (Tb) infection caused by mycobacterium tuberculosis or other mycobacterium species is a major communicable disease worldwide. TbP occurs in 4% - 10% of patients with extra pulmonary tuberculosis [2]. Active TbP can occur through hematogenous spread from active pulmonary lesions, rupture of infected caseous abdominal lymph nodes or reactivation of latent peritoneal foci. Diagnosis of TbP is challenging owing to its protean clinical manifestations and the difficulty in obtaining specimens for tissue culture. Whereas a histological finding of caseating granuloma is considered required for definitive diagnosis of TbP, the literature documents the occurrence of non-caseating granulomas in peritoneal Tb [5]. Due to increases of international travel and the frequency of immune suppressive diseases such as acquired immune deficiency syndrome (AIDS), physicians worldwide should be aware of TbP. Unless a high degree of suspicion is maintained, the diagnosis can be missed or delayed, resulting in increased morbidity and mortality [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
