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[Tuberculosis peritonitis: an always present disease. About 4 new cases]
S Robaday1, C Belizna, J M Kerleau
1Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France.
La Revue De Medecine Interne
|June 11, 2005
Summary
Tuberculous peritonitis, a rare but serious condition, often presents with lymphocytic ascites. Early diagnosis, particularly with peritoneal biopsy, is crucial for effective treatment of this infectious disease.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Immunology
Background:
- Tuberculous peritonitis is a significant health concern, particularly in developing nations and among individuals with acquired immune deficiency syndrome (AIDS).
- While uncommon in France, the disease necessitates a review of its epidemiological, clinical, and therapeutic aspects.
Observation:
- A case series involving four patients, including immigrants and one with AIDS, presented with fever, abdominal pain, anorexia, weight loss, and ascites.
- Initial biological and radiological assessments were inconclusive, with ascitic fluid analysis revealing lymphocytic predominance but negative Ziehl-Neelsen stains.
Findings:
- Laparoscopic examination, combining visual inspection and histological analysis, confirmed tuberculous peritonitis.
- Lymphocytic ascites should prompt consideration of tuberculous peritonitis, even in low-prevalence areas.
Implications:
- An aggressive diagnostic strategy, emphasizing peritoneal biopsy, is recommended for diagnosing tuberculous peritonitis.
- Further research is needed to establish the diagnostic utility of PCR amplification in ascitic fluid for tuberculous peritonitis.