Peritoneal tuberculosis presenting as pyrexia of unknown origin in immigrants

Three immigrant patients with peritoneal tuberculosis seen over a three year period are discussed. All three patients presented with fever and minimal abdominal signs. One patient developed ascites while under investigation. In all cases, the fever was prolonged, liver enzymes were elevated and the ESR was raised. Two patients required laparotomy to make the diagnosis, and in the third tubercle bacilli were grown from the ascitic fluid. The difficulties in diagnosis are discussed.