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[A case of tuberculous peritonitis]
Motoaki Tanigawa1, Kimimasa Saito
1Department of Respiratory Medicine, Yamada Red Cross Hospital, 810, Takabuku, Misono-mura, Watarai-gun, Mie 516-0805 Japan. yrch2nai@yamada.jrc.or.jp
Kekkaku : [Tuberculosis]
|December 21, 2005
Summary
Tuberculous peritonitis, a rare cause of ascites, was rapidly diagnosed using Mycobacterium tuberculosis (MT) DNA detection via PCR and adenosine deaminase (ADA) activity. Early diagnosis aids prompt treatment of this serious condition.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pulmonology
Background:
- Tuberculous peritonitis is a rare but serious condition often presenting with non-specific symptoms.
- Unexplained ascites requires thorough investigation to rule out infectious causes.
Observation:
- A 73-year-old man presented with fever and massive ascites, initially showing no specific findings on endoscopy or CT scan.
- Ascitic fluid analysis revealed Mycobacterium tuberculosis (MT) DNA by PCR and elevated adenosine deaminase (ADA) activity (127.6 U/l).
- Pulmonary tuberculosis and tuberculous pleuritis were also diagnosed based on chest CT and sputum analysis.
Findings:
- Polymerase chain reaction (PCR) detection of Mycobacterium tuberculosis (MT) DNA in ascites.
- Elevated ascitic adenosine deaminase (ADA) activity as a key diagnostic marker.
- Successful treatment with a 6-month regimen of standard anti-tuberculosis drugs.
Implications:
- MT DNA PCR and ADA measurement in ascites can facilitate rapid diagnosis of tuberculous peritonitis.
- Early diagnosis and treatment are crucial for managing tuberculous peritonitis and associated conditions.
- Non-invasive diagnostic methods should be considered before resorting to invasive procedures like laparoscopy.
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