Primary peritoneal tuberculosis, a forgotten localization. Case report.

Area of Science:

• Medicine
• Infectious Diseases
• Gastroenterology

Background:

• Tuberculosis (TB) typically affects the lungs, but extrapulmonary manifestations are common.
• Primary peritoneal tuberculosis is a rare form of TB, often challenging to diagnose.
• Ascites, night sweats, and weight loss are non-specific symptoms that can indicate various conditions.

Observation:

• A young, nulliparous woman presented with progressive ascites, night sweats, and weight loss.
• Initial clinical and paraclinical evaluations did not suggest pulmonary TB or other common causes of ascites.
• Laparoscopy revealed significant ascites and granulomatous peritoneal infiltration with normal female reproductive organs.

Findings:

• Diagnostic tests confirmed tuberculosis (TB) as the cause of the peritoneal condition.
• The findings indicated primary and isolated involvement of the peritoneum by TB, without evidence of pulmonary TB.
• Histopathological examination confirmed granulomatous inflammation characteristic of TB.

Implications:

• This case underscores that primary peritoneal tuberculosis can occur without concurrent pulmonary disease.
• It emphasizes the need for clinicians, particularly in high-incidence regions, to include peritoneal TB in their differential diagnosis for unexplained ascites.
• Raising awareness of this rare presentation can improve diagnostic accuracy and patient outcomes for peritoneal tuberculosis.