Chapter 26 : Tuberculous Peritonitis

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Abdominal tuberculosis (TB), most common in the developing world ( ), is not entirely uncommon in the United States and Europe. Patients with AIDS, immigrants from areas where TB is endemic, Native Americans on reservations, the urban poor, and the elderly are at particular risk ( ). TB rates have decreased from 52.6 cases per 100,000 population in 1953 to 4.2 per 100,000 population in 2008 to 3.0 per 100,000 in 2014 ( ). While the United States experienced a temporary resurgence in the late 1980s and early 1990s, this has clearly abated and recent rates appear to be plateauing ( ). The case rate among those born outside the United States is 13 times higher than for those born in the United States, for whom the rate is exceedingly low, at 1.2 cases per 100,000 ( ). Interestingly, the proportion of extrapulmonary TB cases has increased (from 16% in 1993 to 20% in 2008). Peritoneal TB, the principal but not the only form of intra-abdominal TB, accounts for 6.1% of all extrapulmonary TB cases ( ). Symptoms and signs of peritoneal TB are nonspecific, and a high index of suspicion needs to be maintained to make the diagnosis in a timely manner. Here, we review the epidemiology, pathogenesis, clinical features, available diagnostic techniques, and therapy of tuberculous peritonitis.

Citation: Vaid U, Kane G. 2017. Tuberculous Peritonitis, p 433-438. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0006-2016
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Figure 1

Miliary seedlings on peritoneum and serosal surface of bowel with dense adhesions. Reproduced from reference 64, per CC BY 2.0 (https://creativecommons.org/licenses/by/2.0/).

Citation: Vaid U, Kane G. 2017. Tuberculous Peritonitis, p 433-438. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0006-2016
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Table 1

Clinical and laboratory features of tuberculous peritonitis

Citation: Vaid U, Kane G. 2017. Tuberculous Peritonitis, p 433-438. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0006-2016

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