Case Of Tuberculous Peritonitis Research Articles

A case of tuberculous peritonitis accompanied by tuberculous pleuritis

Tuberculous peritonitis is a form of extrapulmonary tuberculosis, a peritoneal or visceral inflammation caused by Mycobacterium tuberculosis. The disease is rarely independent, but is usually a continuation of the tuberculosis process elsewhere, especially pulmonary tuberculosis. We report a case of TB peritonitis accompanied by TB pleurisy, a 29-year-old female patient with complaints of an enlarged abdomen, heartburn, fever, diarrhea, and decreased appetite. Treatment history was Acitral, Zinc, and Metronidazole. On physical examination, it was found that the general condition was weak and the axilla temperature was 39.5ºC. Thorax examination; decreased vesicular sound on the left chest. Abdominal examination; found distension, epigastric tenderness, undulation, shifting dullness, checkerboard phenomenon, and increased bowel noise. Laboratory examination of complete blood; within normal limits. Complete stool; yellow color, mucus (+), leukocytes 4-6/LPB, bacteria (+). The thorax photo showed left pleural effusion, BOF 3 position: ascites. Abdominal ultrasound results: thickening of the peritoneum, ascites, suspected TB peritonitis. Results of ascites and pleural fluid analysis: rivalta (+) and Adenosine Deaminase (ADA) increased. So that from anamnesis, physical examination, supporting examination can be established diagnosis of TB Peritonitis and TB Pleuritis, followed by OAT therapy; FDC for 12 months. From this case it can be concluded that clinical and supporting examinations (radiology) are needed to make a correct diagnosis and body fluid analysis examinations can help confirm the diagnosis.

Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis.

It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous peritonitis or peritoneal tuberculosis between Jan 2020 to Dec 2021. The study aimed to identify the clinical and radiological features differentiating the two entities. We included 44 cases of tuberculous peritonitis and 45 cases of peritoneal carcinomatosis, with a median age of 31.5 (23.5-40) and 52 (46-61) years, respectively (p ≤ 0.001). Fever, past history of tuberculosis, and loss of weight were significantly associated with tuberculous peritonitis (p ≤ 0.001, p = 0.038 and p = 0.001). Pain in the abdomen and history of malignancy were significantly associated with peritoneal carcinomatosis (p = 0.038 and p ≤ 0.001). Ascites was the most common radiological finding. Loculated ascites, splenomegaly and conglomeration of lymph nodes predicted tuberculous peritonitis significantly (p ≤ 0.001, p = 0.010, p = 0.038). Focal liver lesion(s) and nodular omental involvement were significantly associated with peritoneal carcinomatosis (p = 0.011, p = 0.029). The use of clinical features in conjunction with radiological findings provide better diagnostic yields because of overlapping imaging findings.

PERITONITE TUBERCULEUSE : CIRCONSTANCES DE DECOUVERTE, PRISE EN CHARGE ET FACTEURS PRONOSTIQUES AU SERVICE DE CHIRURGIE GENERALE DU CHU IGNACE DEEN.

Summary The aim of this study was to report our experience in the management of tuberculous peritonitis in the general surgery department of the Ignace Deen National Hospital, Conakry University Hospital. Material and method:Ten-year retrospective descriptive study (January 2013 to December 2022) carried out in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. All complete records of patients admitted for tuberculous peritonitis and confirmed by bacteriology and anatomical pathology were included in the study. Sociodemographic, clinical, therapeutic and prognostic variables were studied. Results:In the course of this study, we collated 41 cases of tuberculous peritonitis out of 4366 hospitalizations in the general surgery department of the Ignace Deen national hospital/CHU in Conakry, representing 0.94% of the department's total activity. Mean age was 58.97 years, with extremes of 12 and 77 years. HIV was associated with TBP in 56.1% of cases. Symptoms were dominated by fever (100%), abdominal pain (100%), weight loss (97.6%) and ascites (97.6%). The diagnosis was suspected preoperatively in all cases and confirmed by bacteriology and pathological anatomy. Treatment was based on two months' RHZE and four months' RH, on a short six-month regimen in 95.1% of cases. L’évolution a été majoritairement favorable dans 97,56%. Nous avons enregistré 3 décès. The majority of cases progressed favorably (97.56%). We recorded 3 deaths. Conclusions: Tuberculous peritonitis, reputed to be rare, has seen a resurgence in incidence with the advent of HIV. Careful questioning can help avoid unnecessary laparotomies. Key words: Tuberculous peritonitis, circumstances of discovery, treatment, prognosis, Ignace Deen.

A Very High Ca-125 Level Is Not Always Malignant: A Case-Based Experience From Tuberculosis Patient

CA-125 is a serum marker that is raised in various malignant and non- malignant conditions, but a very high rise (>1000 U/mL) almost always suggests ovarian malignancy. Here we report a rare case of tuberculous peritonitis in a 58-year-old woman who presented with gradually progressive abdominal distension and weight loss, and her CA-125 level was >1000 U/mL. Initially suspecting this as a case of ovarian malignancy, ascitic fluid study to detect malignant cells and a contrast CT scan of the abdomen was done, but the results didn’t suggest any malignancy. Finally, diagnostic laparoscopy was done and tuberculous peritonitis was diagnosed by peritoneal biopsy and histopathology. This case is an excellent example showcasing the importance of tissue diagnosis over indirect supportive tests, and it also suggests that clinical suspicion of tuberculosis in an endemic zone should always be there even if the patient has very high CA-125 level. Bangladesh J Medicine 2022; 33: 49-51

Tuberculous peritonitis in peritoneal dialysis: report of three cases

Tuberculous peritonitis is a rare but dreaded complication in peritoneal dialysis.
 We report three cases of tuberculous peritonitis diagnosed in our PD center at over a period of 15 years.
 They are a woman and two men aged 50, 45 and 64 respectively.
 The diagnosis of tuberculous peritonitis was suspected in front of a many of clinical (AEG, abdominal pain, cloudy liquid), biological (inflammatory syndrome, the dialysate liquid with lymphocyte predominance and negative culture) and or radiological (abdominal lymphadenopathy) arguments.
 It was confirmed by the demonstration of Mycobacterium Tuberculosis in the dialysate by GeneXpert or by culture on LOWENSTEIN Jensen medium in 2 cases, and the characteristic appearance on anatomopathological examination in only 1 case.
 The evolution under antituberculous treatment was favorable, with recourse to the ablation of
 The diagnosis of tuberculous peritonitis in peritoneal dialysis is difficult and often late because the clinical signs is non-specific. It should be considered in the presence of any culture-negative peritonitis that is refractory to empirical treatment.
 Bacteriological or histological confirmation should not delay the start of anti-tuberculosis treatment because early diagnosis and rapid initiation of treatment are the keys to recovery and the only guarantee of a good prognosis.

Cases of purulent and lumpy peritonitis treated by abdominal dissection and drainage

Cases of tuberculous peritonitis, cured by a section of the abdominal cavity, are no longer particularly rare in the medical literature. But the value of the 3 cases reported by the author is increased by the fact that the condition of all three patients was traced within 2 years after the operation.

A Case of Tuberculous Peritonitis Diagnosed after Surgery for an Incarcerated Umbilical Hernia

A Case of Tuberculous Peritonitis Diagnosed after Surgery for an Incarcerated Umbilical Hernia

A case of tuberculous peritonitis in a 60-year-old woman diagnosed using exploratory laparoscopy.

A case of tuberculous peritonitis in a 60-year-old woman diagnosed using exploratory laparoscopy.

Two Cases of Tuberculous Peritonitis Diagnosed with A Laparoscopic Biopsy

Two Cases of Tuberculous Peritonitis Diagnosed with A Laparoscopic Biopsy

A case of tuberculous peritonitis diagnosed with a laparoscope

A case of tuberculous peritonitis diagnosed with a laparoscope

A case of tuberculous peritonitis diagnosed by way of laparoscopy

Objective: Tuberculous peritonitis (TBP) is a rare form of extrapulmonary tuberculosis. The diagnosis of TBP is particularly challenging in children. Herein, we present a child who had been admitted with ascites and diagnosed as TBP by way of laparoscopy. Case report: A previously healthy 3-year-old girl was presented with newly onset fever and abdominal pain. She had abdominal distention and generalized tenderness on palpation. Abdominal percussion revealed dullness on nonspesific locations. Abdominal ultrasonography showed diffuse ascites with multiple septations, and paracenthesis performed detected exudative material with plenty of polmorphonuclear leukocytes. She was started on antibiotherapy. Lymphocytic pleocytosis persisted on control peritoneal lavage sample. Acid- resistant bacteria were not seen in the peritoneal fluid, tuberculous polymerase chain reaction test and tuberculous cultures were negative. Cytopathologic examination was not suggestive of malignancy. Diagnostic laparoscopy was compatible with TBP. Adenosine deaminase (ADA) level in peritoneal fluid was increased. She was started on quadruple antituberculous treatment including isoniazid (INH), rifampicin (RIF), pyrazinamide and ethambutol. On the 2nd month of antituberculous therapy, abdominal circumference showed obvious regression. She continued on INH-RIF therapy and is still being followedup in our outpatient clinic. Conclusion: Explorative laparoscopy and peritoneal fluid ADA level are very helpful in the diagnosis of TBP

A Case of Tuberculous Peritonitis in a Patient with Ankylosing Spondylitis during Infliximab Therapy

593 Copyrightc 2015 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received: 2015. 4. 13 Revised: 2015. 5. 8 Accepted: 2015. 5. 29

A series of 16 cases of Tuberculous peritonitis

Abdominal tuberculosis is one of the common extra pulmonary tuberculousinfection.Its clinical presenta tion is variable and as most of the investigations arenon-s pecific and less sensitive, may sometimes become di agnostic dilemma.Tuberculous peritonitis is one of the uncom mon presentation.The risk is increased with cirrhosis,HIV,Diabetes Mellitus and underlying mali gnancy. The clinical profile of 16 patients with tu berculous peritonitis is discussed in this report.Clinical pr esentation together with ultrasonographic, blood an d ascitic fluid analysis help in thediagnosis of tuberculous perito nitis in the absence of laparoscopy and tissue biop sy.Strong suspicion of the conditionbased on clinical present ation along with other investigations is important to start ATT in endemic country like India.

Tuberculous Peritonitis Mimicking Malignancy during Adalimumab Therapy in a Patient with Rheumatoid Arthritis

We present a case of tuberculous peritonitis in a 46-year-old woman with rheumatoid arthritis treated with adalimumab, and we review the association between anti-tumour necrosis factor therapy and tuberculosis. This case illustrates that tuberculosis can develop with atypical clinic and uncertain laboratory findings and may mimic malignancies during adalimumab therapy.

Tuberculous peritonitis in pregnancy: a case report

IntroductionTuberculous peritonitis is one of the least common forms of extrapulmonary tuberculosis. In the literature, few cases in pregnancy have been previously published. Tuberculous peritonitis in pregnancy is a diagnostic challenge, especially in the absence of lung involvement. It mimics other diseases and clinical presentation is usually non-specific, which may lead to diagnostic delay and development of complications.Case presentationWe report here a new case of tuberculous peritonitis that occurred in a 31-year-old Caucasian pregnant woman at 22 weeks' gestation. She was complaining of abdominal pain, nausea and vomiting. These symptoms appeared 6 months prior to presentation. Initially, they were attributed to pregnancy, but they progressively became more severe during subsequent weeks. A laparoscopy showed the presence of yellow-white nodules on the peritoneal surface and a biopsy demonstrated caseous necrotic granuloma. She made a good physical recovery after being placed on antituberculous chemotherapy and gave birth to a healthy male neonate of 3100g at 37 weeks' gestation by vaginal delivery.ConclusionsExtreme vigilance should be used when dealing with unexplained abdominal symptoms to ensure timely diagnosis of tuberculous peritonitis. Diagnosis often requires a histopathological examination. In these patients early diagnosis with early antituberculous therapy are essential to prevent obstetrical and neonatal morbidity.

A case of tuberculous peritonitis by effective laparoscopic biopsy to achieve differential diagnosis

A case of tuberculous peritonitis by effective laparoscopic biopsy to achieve differential diagnosis

Complicated and delayed diagnosis of tuberculous peritonitis

BackgroundPeritoneal tuberculosis is very rare in European countries. However, its incidence is increasing due to the continued immigration of people from endemic areas affected by tuberculosis.Case Report:The authors report a case of tuberculous peritonitis in a 46-year-old male patient from North Africa. The presenting symptoms of the disease were hiccups, dyspepsia, anorexia, and weight loss. Physical examination revealed an abdominal distension that suggested the presence of ascites. Subsequent investigations of ultrasound and computed tomography of the abdomen revealed the presence of massive ascites. A diagnostic laparoscopy went on to highlight a macro micronodular degeneration of the peritoneum. Histological examination showed the presence of epithelioid granulomas with typical Langhans cells with areas of caseous necrosis. The diagnosis of tuberculous peritonitis was then made, and the ascites quickly disappeared in response to the anti-mycobacterial therapy. The patient remained free of symptoms after 6 months of clinical follow-up.Conclusions:In this case the clinical diagnosis was complicated and delayed due to clinicians’ suboptimal knowledge of and experience with this disease. This case demonstrates why laparoscopy with peritoneal biopsy should be the gold standard in any clinical suspicion.

A Case of Tuberculous Peritonitis Diagnosed by Laparoscopy and Biopsy

A Case of Tuberculous Peritonitis Diagnosed by Laparoscopy and Biopsy

Tuberculous Peritonitis: The Closer You Go, the More Confused You Get

We read the article entitled ‘‘Comparison between Laparoscopy and Noninvasive Tests for the Diagnosis of Tuberculous Peritonitis’’ by Hong et al. [1] with great interest. The authors presented a retrospective study of 60 patients who underwent diagnostic laparoscopy for either undiagnosed ascites (n = 19) or a condition that needed to be differentiated from peritoneal carcinoma (n = 41). Forty-one patients were diagnosed with tuberculous peritonitis (TBP). The positive and negative results of diagnostic laparoscopy were compared with ascitic deaminase levels [30 U/l and ascitic lactate dehydrogenase levels [90 U/l. The authors concluded that laparoscopy with combined biopsy is the most sensitive and the quickest method for diagnosing tubercular peritonitis. We would like to make the following observations regarding this article. The authors chose to present their results as mean ± SD. This method is always not representative, especially if data is nonuniform. This is apparent by looking at the duration of symptoms in the patients with TBP: 40 ± 57 (range, 3–360). Median ± interquartile range is a preferable method to represent the nonuniform data compared with mean ± SD [2]. The diagnosis of TBP was considered definitive by the authors, on the basis of either caseous granuloma or positive bacteriological results for M. tuberculosis. The diagnosis was considered probable in the presence of suggestive clinical and laparoscopic findings and noncaseous granuloma without positive bacteriologic findings. The authors did not mention how many patients were in the category of probable diagnosis or how many of them actually proved to be definitive case of TBP after favorable clinical response to antituberculosis therapy. The authors reported that biopsy tissues were deemed inadequate for the diagnosis in 12 of 60 cases. However, all of these patients were considered while assessing the presence of granuloma/caseous granuloma under the heading of laparoscopy in Table 4 [1]. This needs further clarification. The diagnosis of abdominal tuberculosis is classically based on microbiological confirmation [3]. Although the yield may be less, positive acid fast staining (AFB) and M. tuberculosis culture results confirm the diagnosis of tuberculosis unequivocally. The authors performed AFB of peritoneal biopsy specimen in 22 and culture for M. tuberculosis in 6 of 60 patients. Selective use of these investigations rules out the opportunity of exploring their full potential in the diagnosis of TBP. The authors mentioned that ascites was present in 92.7% (38/41) of patients of TBP. Table 2 shows that acid fast staining was conducted in 48 patients, and M. tuberculosis culture and PCR was undertaken in 48 and 39 patients respectively. The authors did not indicate why these investigations were selectively performed in a few patients and not in all patients. We believe that AFB staining, which is an inexpensive and freely available investigation, should be performed in the ascitic fluid of all patients suspected to have TBP. The authors stated that an abnormal chest X-ray was seen in 20 of 41 patients of TBP and active concomitant pulmonary disease was present in 8 patients (20%). It becomes imperative to know whether the sputum of these patients was examined for the presence of AFB. It will be interesting to know how many of these sputum AFBpositive patients were ultimately found to have TBP. P. K. Garg (&) B. K. Jain D. Mohanty Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India e-mail: dr.pankajgarg@gmail.com

Fausse sérologie syphilitique positive isolée découverte en début de grossesse : pronostic obstétrical (7 cas)

With the introduction of effective antituberculous chemotherapy, the clinical outcome of tuberculous peritonitis depends much on the diagnostic accuracy of this disease entity. This review summarizes the current state-of-the-art thinking regarding the protean manifestation and diagnostic modalities of this major infectious disease.This review was compiled after an extensive search of the current and historical literature, comprising 1,070 cases of tuberculous peritonitis. A number of important areas were highlighted, with emphasis on the diagnostic value and clinical impact of peritoneal biopsy.We believe an aggressive diagnostic approach, particularly with peritoneal biopsy, is warranted for the diagnosis and timely treatment of tuberculous peritonitis.