Problematic Diagnosis of a Patient with Tuberculosis Peritonitis

Abstract

Tuberculosis Peritonitis is a parietal or visceral peritoneal inflammation caused by Mycobacterium tuberculosis bacteria. Pathogenesis Tuberculosis peritonitis is preceded by infection with M. tuberculosis followed by spreading to the peritoneum. This is a report of a young female patient with a major complaint of overall abdominal pain and weight loss accompanied by other non-specific clinical symptoms such as fever, enlargement (ascites), with malnutrition, and a history of the patient's child being treated for tuberculosis lymphadenitis. The investigation showed anemia, erythrocyte sedimentation rate (ESR) and increased CRP, and ascites fluid analysis showed an exudate, ascites glucose ratio with blood < 0.96. Radiological examination of abdominal ultrasound found ascites, with abdominal CT scan examination finding thickening of the intestinal wall, supporting tuberculosis (TB) with bilateral ovarian cyst appearance. Diagnosis of tuberculosis peritonitis is based on histologic tiss ue examination by laparotomy. This laparotomy examination is performed because anamnesis, physical examination, and other support are not able to determine a definitive diagnosis. Furthermore, patients receive Fixed Drug Combination (FDC) therapy consisting of Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol for 2 months, followed by a combination of Rifampicin and Isoniazid for 7-10 months. The prognosis of tuberculosis peritonitis is sufficient if the diagnosis is immediate and patients are adequately treated