A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis

Approximately 2 billion people, which is about one third of the world’s population, are infected with tuberculosis (TB). Around 10% of infected people will develop active TB at one point in their lifetime. We present a rare case of a 68-year-old male who presented to the emergency department with a...

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Main Authors: Jose Ruiz, Maedeh Ganji, Catarina Canha, Carmen Isache
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2018/8136476
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author Jose Ruiz
Maedeh Ganji
Catarina Canha
Carmen Isache
author_facet Jose Ruiz
Maedeh Ganji
Catarina Canha
Carmen Isache
author_sort Jose Ruiz
collection DOAJ
description Approximately 2 billion people, which is about one third of the world’s population, are infected with tuberculosis (TB). Around 10% of infected people will develop active TB at one point in their lifetime. We present a rare case of a 68-year-old male who presented to the emergency department with a 2-week progressive dyspnea. In addition, the patient complained of generalized weakness, subjective fevers, and abdominal pain in the right upper quadrant. Ascites was noted on physical exam, and the patient underwent a diagnostic paracentesis with initial workup that was unrevealing for underlying etiology. Abdominal computed tomography was done, which revealed peritoneal carcinomatosis. He underwent omental biopsy which showed necrotizing granulomatous inflammation with rare acid-fast bacilli. Repeat biopsy was culture positive for mycobacterium tuberculosis complex. The patient was started on rifampin, isoniazid, pyrazinamide, and ethambutol with improvement of his symptoms days after treatment was started. This case demonstrates how the diagnosis of peritoneal tuberculosis can be elusive. Physicians must be aware of this disease and its behavior in high risk patients, also of the current diagnostic limitations.
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spelling doaj-art-9df9f596531d40af92006917205102fa2025-02-03T01:22:12ZengWileyCase Reports in Infectious Diseases2090-66252090-66332018-01-01201810.1155/2018/81364768136476A Challenging Diagnosis of Ascites: A Case Report of Peritoneal TuberculosisJose Ruiz0Maedeh Ganji1Catarina Canha2Carmen Isache3University of Florida-COM, Division of Internal Medicine, Jacksonville, FL, USAUniversity of Florida-COM, Division of Internal Medicine, Jacksonville, FL, USAUniversity of Florida-COM, Division of Internal Medicine, Jacksonville, FL, USAUniversity of Florida-COM, Division of Internal Medicine, Jacksonville, FL, USAApproximately 2 billion people, which is about one third of the world’s population, are infected with tuberculosis (TB). Around 10% of infected people will develop active TB at one point in their lifetime. We present a rare case of a 68-year-old male who presented to the emergency department with a 2-week progressive dyspnea. In addition, the patient complained of generalized weakness, subjective fevers, and abdominal pain in the right upper quadrant. Ascites was noted on physical exam, and the patient underwent a diagnostic paracentesis with initial workup that was unrevealing for underlying etiology. Abdominal computed tomography was done, which revealed peritoneal carcinomatosis. He underwent omental biopsy which showed necrotizing granulomatous inflammation with rare acid-fast bacilli. Repeat biopsy was culture positive for mycobacterium tuberculosis complex. The patient was started on rifampin, isoniazid, pyrazinamide, and ethambutol with improvement of his symptoms days after treatment was started. This case demonstrates how the diagnosis of peritoneal tuberculosis can be elusive. Physicians must be aware of this disease and its behavior in high risk patients, also of the current diagnostic limitations.http://dx.doi.org/10.1155/2018/8136476
spellingShingle Jose Ruiz
Maedeh Ganji
Catarina Canha
Carmen Isache
A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
Case Reports in Infectious Diseases
title A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
title_full A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
title_fullStr A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
title_full_unstemmed A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
title_short A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis
title_sort challenging diagnosis of ascites a case report of peritoneal tuberculosis
url http://dx.doi.org/10.1155/2018/8136476
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