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Tuberculous peritonitis in a young female diagnosed using mini-laparotomy: a case report
A C Wittich1, H L Olson, S A Elg
1Department of Obstetrics & Gynecology, Tripler Army Medical Center, Honolulu, HI 96859-5000.
Military Medicine
|November 1, 1994
Summary
Tuberculous peritonitis can mimic ovarian cancer in young women. Early diagnosis requires microbiological confirmation, as initial tests may be negative for acid-fast bacilli (AFB).
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Tuberculous peritonitis often presents with nonspecific symptoms like abdominal pain, ascites, and fever.
- Clinical presentation can mimic ovarian malignancy, leading to diagnostic challenges and delays.
- Diagnosis is frequently complicated by negative initial microbiological and immunological tests.
Observation:
- An 18-year-old female presented with symptoms suggestive of ovarian malignancy.
- Initial investigations, including sputum analysis, purified protein derivative (PPD) testing, and peritoneal fluid/omentum biopsy for acid-fast bacilli (AFB), were negative.
- The patient underwent a mini-laparotomy for further evaluation.
Findings:
- Omental biopsy from mini-laparotomy revealed granulomatous inflammation.
- Microbiological analysis of the omental biopsy confirmed the isolation of acid-fast bacilli (AFB).
- Tuberculous peritonitis was definitively diagnosed based on these findings.
Implications:
- Highlights the importance of considering tuberculous peritonitis in young females with unexplained abdominal symptoms.
- Underscores the limitations of initial diagnostic tests for tuberculous peritonitis.
- Emphasizes the value of surgical biopsy and microbiological culture for definitive diagnosis of tuberculous peritonitis.