Tuberculous peritonitis

Two patients with tuberculous peritonitis are described to exemplify some of the diagnostic problems that may be encountered in this rare disease. Both presented with fever, abdominal pain and a deterioration in their general condition. In both cases Ziehl-Neelsen staining and animal inoculation were negative. In the first patient, who underwent repeated hospitalization and investigation, the diagnosis was established following a therapeutic trial with antituberculous drugs administered after unsuccessful treatment of a cecocutaneous fistula that developed after drainage of a periappendicular abscess and appendectomy. In the second patient, the diagnosis was confirmed at laparatomy. Since bacteriological studies often fail to render a positive diagnosis, it is suggested that the clinical picture together with a histological finding compatible with tuberculous peritonitis should be sufficient for diagnosis and the institution of treatment.