Peritoneal tuberculosis in an immunocompetent patient: A case report

Area of Science:

• Infectious Diseases
• Gastroenterology
• Oncology

Background:

• Tuberculosis (TB) is endemic in Colombia, with a high prevalence of pulmonary TB in immunocompetent individuals.
• Peritoneal tuberculosis is an uncommon and challenging diagnosis, often presenting with nonspecific symptoms.

Observation:

• A 24-year-old female presented with constitutional and gastrointestinal symptoms, including weight loss, ascites, and abdominal pain.
• Initial workup (paracentesis, ultrasound, CT scan) ruled out malignancy and portal hypertension.
• Diagnostic laparoscopy revealed a miliary pattern on the peritoneum, uterus, fallopian tubes, and omentum, suggesting peritoneal TB.

Findings:

• Microbiological confirmation followed initiation of anti-tuberculosis therapy.
• The case highlights the diagnostic difficulties of abdominal TB, particularly in patients without apparent risk factors.
• Clinical and paraclinical data can be inconclusive, necessitating peritoneal biopsy and empirical treatment.

Implications:

• This case underscores the importance of considering peritoneal tuberculosis in the differential diagnosis of unexplained abdominal symptoms.
• Early recognition and prompt treatment are vital for favorable outcomes in peritoneal TB.
• Further research into diagnostic modalities for peritoneal TB may improve patient management.