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Tuberculous peritonitis
Akiko Makiyama1, Yusuke Okuyama, Tatsuya Okajima
1Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Journal of Gastroenterology
|January 10, 2004
Summary
Tuberculous peritonitis is a serious condition presenting as abdominal fullness and fever. Gallium-67 scintigraphy aids diagnosis in suspected cases, especially when initial cultures are negative.
Area of Science:
- Infectious Diseases
- Radiology
- Gastroenterology
Background:
- Tuberculous peritonitis is a significant cause of ascites, particularly in endemic regions.
- Diagnosis can be challenging due to nonspecific symptoms and negative initial cultures.
Observation:
- A 24-year-old male presented with abdominal fullness and fever, exhibiting massive ascites with septa on imaging.
- Gallium-67 scintigraphy revealed diffuse, intense abdominal uptake.
- Initial cultures were negative, but lung CT showed tuberculous changes, later confirmed by positive sputum for Mycobacterium tuberculosis.
Findings:
- The case highlights the diagnostic utility of gallium-67 scintigraphy in suspected tuberculous peritonitis.
- Computed tomography (CT) of the lung revealed subtle findings consistent with tuberculosis.
- Delayed sputum culture confirmed Mycobacterium tuberculosis, leading to the diagnosis of active tuberculous peritonitis.
Implications:
- Tuberculous peritonitis should be considered in patients with unexplained massive ascites and fever.
- Gallium-67 scintigraphy is a valuable tool for early diagnosis when suspicion is high.
- Prompt antituberculous therapy is crucial for managing active tuberculous peritonitis.