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Peritoneal tuberculosis mimicking peritoneal carcinomatosis
Mehmet Akce1, Sarah Bonner1, Eugene Liu1
1Department of Internal Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Michigan, MI 48106, USA.
Case Reports in Medicine
|April 10, 2014
Summary
Tuberculosis can mimic peritoneal carcinomatosis, presenting with ascites and omental caking. Early diagnosis through biopsy and prompt treatment with anti-tuberculosis medication led to complete resolution.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Peritoneal carcinomatosis presents with ascites and omental caking, often mimicking other intra-abdominal pathologies.
- Tuberculosis can manifest with similar symptoms, posing a diagnostic challenge.
Purpose of the Study:
- To highlight a case of tuberculosis mimicking peritoneal carcinomatosis.
- To emphasize the importance of biopsy in diagnosing rare presentations of tuberculosis.
Main Methods:
- A 67-year-old male with symptoms suggestive of malignancy underwent imaging and diagnostic procedures.
- Computerized tomography (CT) revealed ascites and omental caking.
- Exploratory laparotomy with peritoneal biopsies was performed, and acid-fast bacilli were identified.
Main Results:
- Biopsy revealed necrotizing granulomas and acid-fast bacilli on Ziehl-Neelsen stain.
- Mycobacterium tuberculosis was identified and sensitive to standard anti-tuberculosis drugs.
- Six months of treatment resulted in complete resolution of ascites and peritoneal thickening.
Conclusions:
- Tuberculosis should be considered in the differential diagnosis of peritoneal carcinomatosis, especially in endemic areas.
- Prompt diagnosis and treatment of peritoneal tuberculosis are crucial for favorable outcomes.
- Multidrug therapy for Mycobacterium tuberculosis effectively resolved the patient's condition.
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