A Case Report on Peritoneal Tuberculosis in an Immunocompromised Patient

R. S R, S. B S, Shaiju S Dharan, Dhanya Dharman
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Abstract

Background: Peritoneal tuberculosis (PTB) is one of the most challenging forms of extra pulmonary tuberculosis. Abdominal TB cases make up above 3% of all extra pulmonary TB as per the Index TB Guidelines. PTB is commonly due to reactivation of latent tuberculosis in the peritoneum. Numerous cases were still misdiagnosed due to nonspecific presentation. The golden standard for diagnosis is laparoscopic biopsy. Presenting signs and symptoms of PTB are unspecific such as ascites, abdominal pain and distension, fever, weight loss, diarrhea/constipation. Peritoneal tuberculosis is a significant cause of ascites in developing countries. The causative agent of peritoneal tuberculosis is Mycobacterium tuberculosis. Case Presentation: In this case study, a 52 year old male had complaints of progressive abdominal distension and fever for 2 weeks. Patient underwent diagnostic paracentesis, upper and lower GI endoscopy, biopsy and gene xpert to confirm peritoneal tuberculosis. Patient with peritoneal TB have gradually progressive abdominal swelling due to ascites and abdominal pain. Conclusion: Peritoneal tuberculosis should be considered in differential diagnosis.  Differential diagnosis, especially in the developing countries or under developed countries.  This case highlights the easy diagnosis of the condition other than the other case reports.
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免疫力低下患者腹膜结核的病例报告
背景:腹膜结核(PTB)是肺外结核病中最具挑战性的形式之一。根据《结核病指南索引》,腹膜结核病例占肺外结核病例的 3%以上。腹腔结核通常是由于潜伏在腹膜内的结核病再次活化所致。由于没有特异性表现,许多病例仍被误诊。诊断的黄金标准是腹腔镜活检。腹膜结核的症状和体征无特异性,如腹水、腹痛和腹胀、发热、体重减轻、腹泻/便秘。腹膜结核是发展中国家腹水的一个重要原因。腹膜结核的病原体是结核分枝杆菌。病例介绍:在本病例研究中,一名 52 岁的男性主诉腹部胀痛和发烧已持续两周。患者接受了诊断性腹腔穿刺术、上下消化道内窥镜检查、活组织检查和基因鉴定,确诊为腹膜结核。腹膜结核患者会因腹水和腹痛而逐渐出现腹部肿胀。结论鉴别诊断时应考虑腹膜结核。 鉴别诊断,尤其是在发展中国家或欠发达国家。 与其他病例报告相比,本病例突出了该病的易诊断性。
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