Diagnosis and management of intra-abdominal tuberculosis

Roberts, Sophie; Newsholme, William; Gibson, T.

doi:10.12968/hmed.2018.79.6.c86

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…Peritoneal involvement is further classified into dry and wet types depending on presence or absence of ascites. The dry type is again divided into fibrotic-fixed and dry-plastic types [ 5 ]. Current theories for peritoneal TB development include tuberculous salpingitis, or hematogenous spread [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of peritoneal TB includes fluid analysis from paracentesis. While fluid acid-fast bacilli (AFB) smear and culture have a relatively low yield (3%) in diagnostic paracentesis, yield may be increased with therapeutic paracentesis if volumes of greater than one liter are removed [ 5 ]. Disadvantages are that AFB smears have high false negative rates and AFB cultures may take up to 8 weeks for growth [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Sen

Brunton

Melchior

et al. 2020

Case Reports in Women's Health

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Peritoneal tuberculosis (TB) is a rare extrapulmonary manifestation of TB with non-specific clinical characteristics which can produce test results mimicking malignancy and granulomatous peritonitis. This case describes a Filipino 59-year-old, nulliparous woman who was admitted with abdominal pain, ascites, and an elevated CA-125 level. Radiographically, peritoneal nodules were visualized and initial suspicion was high for malignancy. Following a bilateral salpingo-oophorectomy and peritoneal biopsy, histology was negative for malignancy but revealed non-caseating granulomas. She was discharged then readmitted with progressive abdominal pain, and a repeat laparoscopic biopsy yielded specimens with growth of acid-fast bacilli (AFB). A delay in diagnosis and treatment of tuberculous peritonitis increases mortality rates, making early diagnosis with laparoscopic biopsy of paramount importance in prompt diagnosis and initiation of therapy. This patient was initiated on standard anti-TB therapy and experienced no complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Sen

Brunton

Melchior

et al. 2020

Case Reports in Women's Health

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“…The most commonly affected sites are the ileum and ileocaecal region 3. In addition to a history of exposure, patient-specific risk factors include HIV infection, immunosuppressive therapy, diabetes mellitus, malignancy and peritoneal dialysis 4…”

Section: Discussionmentioning

confidence: 99%

“…Early initiation of treatment is crucial to minimise morbidity and mortality. Standard antituberculous chemotherapy is the mainstay of treatment, with a recommended minimum duration of 6 months 4. As per a recent meta-analysis, the concurrent use of steroids alongside antituberculous therapy may reduce mortality and complications, such as symptomatic strictures and intestinal obstruction, in peritoneal tuberculosis; however, the external validity of the evidence is limited by the poor quality of existing studies 15.…”

Section: Discussionmentioning

confidence: 99%

Abdominal tuberculosis with a Pseudo-Sister Mary Joseph nodule mimicking peritoneal carcinomatosis

Awad¹,

Pampiglione

Ullah

2019

BMJ Case Rep

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A 46-year-old woman presented in severe abdominal pain on a background of 3 months of weight loss and intermittent vomiting. She had visited East Africa 6 months prior but reported no unwell contacts. On examination, she had generalised abdominal tenderness, distension and a painful paraumbilical swelling. CT scanning confirmed small bowel obstruction and revealed widespread peritoneal nodules, lymphadenopathy, ascites and a soft tissue paraumbilical mass. CA-125 tumour marker was elevated. However, transvaginal ultrasound scanning showed normal-appearing ovaries. She underwent a diagnostic laparoscopy for ascitic fluid analysis and biopsy of omental and peritoneal nodules, which revealed a lymphocytic exudate and caseating granulomas, respectively. Interferon-γ release assay and repeated stains for acid-fast bacilli were negative. She was commenced on antituberculous chemotherapy for a presumed diagnosis of abdominal tuberculosis. Positive culture results 2 weeks later confirmed Mycobacterium tuberculosis infection. The patient experienced a complete resolution of symptoms within 6 weeks of treatment.

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“…La TBP cons tituye del 31-58% de los casos de TBA y la incidencia de TBP entre todas las formas de tuberculosis varía de 0.1% a 0.7% [6]. La coexistencia de tuberculosis pulmonar y TBP se presenta en el 3,5%, sin embargo, la TBA puede ocurrir en ausencia de tuberculosis pulmonar [7]. La TBP usualmente se presenta entre la tercera y cuarta década de la vida, con tasas iguales entre ambos géneros [6,8].…”

Section: Introductionunclassified

Tuberculosis peritoneal en un paciente joven sin comorbilidades. Reporte de caso [Peritoneal tuberculosis in a young without comorbidities patient. Case report]

et al. 2020

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Resumen La Tuberculosis extrapulmonar (TBE) representa el 15–20% de los casos de tuberculosis y el compromiso abdominal ocupa el sexto sitio más común. La tuberculosis peritoneal (TBP), es un problema trascendental de salud pública. Las formas más comunes de TBE en pacientes inmunocompetentes son pleural, linfática y genitourinaria. Existen factores contribuyentes como inmunosupresión, comorbilidades y condiciones socioeconómicas. Se expone el caso de un paciente masculino de 22 años de edad, sin comorbilidades; consulta por dolor abdominal orgánico, síntomas sistémicos, constitucionales y ascitis extraportal, adenosin deaminasa (ADA) positivo, citológico negativo, laparoscopia con lesiones nodulares en peritoneo, con confirmación histopatológica y microbiológica que apoyan el diagnóstico de TBP. Con este caso se pretende contemplar la presentación de esta entidad en un paciente sin inmunodeficiencias secundarias, sospecharla para un tratamiento oportuno que impacte en la morbimortalidad. Abstract Extrapulmonary tuberculosis (TBE) accounts for 15–20% of cases of tuberculosis and abdominal involvement represents the sixth most common site. Peritoneal tuberculosis (TBP) is a transcendental public health problem. The most common forms of TBE in immunocompetent patients are pleural, lymphatic and genitourinary. There are contributing factors such as immunosuppression, comorbidities and socioeconomic conditions. The case it’s about a 22-year-old male patient without comorbidities, who consulted for organic abdominal pain, systemic and constitutional symptoms associated with extraportal ascites. He had positive adenosine deaminase (ADA) in ascites fluid and negative cytological study and laparoscopy with nodular lesions at the peritoneal space, with histopathological and microbiological confirmation that support the diagnosis of TBP. This case aims to contemplate the presentation of this entity in an without secondary immunodeficiency patient, how to suspect it, for initiate a timely treatment that impacts on morbidity and mortality.

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Diagnosis and management of intra-abdominal tuberculosis

Cited by 9 publications

References 10 publications

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Peritoneal tuberculosis: A case report on a rare cause of tumor marker elevation

Abdominal tuberculosis with a Pseudo-Sister Mary Joseph nodule mimicking peritoneal carcinomatosis

Tuberculosis peritoneal en un paciente joven sin comorbilidades. Reporte de caso [Peritoneal tuberculosis in a young without comorbidities patient. Case report]

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