Chapter 24 : Tuberculous Peritonitis

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This chapter reviews the epidemiology, pathogenesis, clinical features, available diagnostic techniques, and therapy of tuberculous peritonitis. Of all sites affected by extrapulmonary tuberculosis (TB), the abdomen is the sixth most common after lymphatic, genitourinary, bone and joint, miliary, and meningeal involvement. Tuberculous peritonitis is predominantly a disease affecting young adults in the third and fourth decades of life but can occur at any age. In a retrospective study, 80% of mycobacterial isolates were identified as and the rest were . Tuberculous peritonitis as the initial manifestation of HIV infection was reported first in 1992. Peritoneal TB is thought to be the result of reactivation of latent foci established in the peritoneum via hematogenous spread to the mesenteric lymph nodes from previous pulmonary infection. The average duration of symptoms prior to diagnosis extends from weeks to months. Peritoneal TB has been classified as the more common ''wet type,'' which is characterized by ascites, and the less common ''plastic or fibroadhesive type,'' which manifests as abdominal masses comprised of adherent bowel loops. Laparoscopic examination and biopsy confirm tuberculous peritonitis in 85 to 90% of cases. The differential diagnosis of tuberculous peritonitis includes the differential diagnosis of ascites as well as the differential diagnosis of granulomatous peritonitis. Granulomatous peritonitis on histopathology may not always be secondary to . The treatment of peritoneal TB is primarily medical. Ascitic fluid cultures have low yield, but peritoneoscopy with biopsy or cultures frequently confirms the diagnosis.

Citation: Vaid U, Kane G. 2011. Tuberculous Peritonitis, p 367-371. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch24

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Table 1.

Clinical and laboratory features of tuberculous peritonitis

Citation: Vaid U, Kane G. 2011. Tuberculous Peritonitis, p 367-371. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch24

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