Abstract
Peritoneal tuberculosis presents high morbi-mortality rates and its prognosis depends on early diagnosis. Symptoms mimic other abdominal diseases, what makes diagnosis difficult. We report clinical and pathological data from 10 tuberculous peritonitis patients admitted to Hospital Hospital Universitario da Universidade de Sao Paulo between 2003 and 2010. Abdominal pain, fever and weight loss were the most frequent symptoms and ascites was observed in half of cases. The serum-ascites albumin gradient determination and adenosine deaminase activity helped to make the diagnosis. Culture growth of Mycobacterium tuberculosis showed low sensitivity. The finding of chronic granulomatous serositis and positive stain for acid fast bacilli in biopsy specimens obtained from laparotomy and laparoscopy were determinant for diagnosis.
Highlights
A tuberculose peritoneal é uma forma rara de tuberculose extrapulmonar descrita pela primeira vez em 1843.1 Dentre o total de casos diagnosticados de tuberculose, o comprometimento peritoneal representa 0,1 a 0,7% de todos os casos, sendo mais comum entre os 35 e 45 anos de idade
Revisamos dados de 10 pacientes internados no Hospital Universitário da Universidade de São Paulo entre 2003 e 2010 com diagnóstico de tuberculose peritoneal
Os sintomas mais comuns foram: dor abdominal (80%), febre (60%), perda de peso (50%) e diarréia (30%)
Summary
Leonardo Gomes da Fonsecaa, Fernando Peixoto Ferraz de Camposb, Aloísio Felipe-Silvac. Tuberculose peritoneal: experiência em um hospital geral. A tuberculose peritoneal apresenta altas taxas de morbimortalidade e o prognóstico dos pacientes depende do diagnóstico precoce. Revisamos dados de 10 pacientes internados no Hospital Universitário da Universidade de São Paulo entre 2003 e 2010 com diagnóstico de tuberculose peritoneal. Febre e perda de peso foram os sintomas mais frequentes e ascite foi observada em metade dos casos. A cultura de bacilo álcool-ácido resistente no líquido ascítico revelou baixa sensibilidade. O achado de serosite crônica granulomatosa com necrose caseosa e a pesquisa do bacilo álcool-ácido resistente nas biópsias obtidas através de laparotomia ou laparoscopia foram determinantes para o diagnóstico.
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