Peritoneal and genital tuberculosis in an adolescent: A challenging diagnosis

Introduction: Extra-pulmonary manifestations of tuberculosis occur in about 20% of cases. Peritoneal and genital tuberculosis are uncommon, especially in children without any comorbidity. Case report: A previously healthy 14-year-old girl, presented complaints of weight loss, anorexia, abdominal pain and fever. On examination, she was febrile, with rebound abdominal tenderness and abdominal distension. Ultrasonography reported peritoneal fluid, fibrin strands and complex cystic lesions in the adnexal region. Laparotomy evidenced multiple peritoneal cysts, purulent exudate with bilateral pyosalpinx. Mycobacterium tuberculosis was isolated in culture and confirmed the diagnosis of Peritoneal Tuberculosis. Antituberculous quadruple therapy and corticosteroids were started, with good clinical response. Conclusions: Peritoneal and genital tuberculosis are uncommon in children, but have high fatality and infertility rate. Due to the nonspecific clinical, laboratory or radiology findings, diagnosis is often delayed. This report highlights the need for a big suspicious index of the disease for an accurate and early diagnosis.