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Aim: To describe the clinical manifestation and the diagnostic process of a patient with peritoneal tuberculosis as a clinical challenge in a tertiary referral center in a Latin American country. Case description: A 61-year-old male patient from the urban area of Cali consulted for edema in the lower limbs, ascites, hyporexia, weight loss, cachexia, thrombocytopenia, elevated transaminases, imaging of splenomegaly and pulmonary, hepatic, and peritoneum nodules. Initially, neoplasia was suspected, but the adenosine deaminase report and histopathology were consistent with the diagnosis of peritoneal tuberculosis. Conclusion: Peritoneal tuberculosis represents the sixth cause of extrapulmonary tuberculosis, after lymphatic, pleural, osteoarticular, genitourinary, and meningeal manifestations. Despite having surveillance systems, peritoneal tuberculosis is still considered the most challenging infectious disease to reach a definitive diagnosis. We present a case of disseminated tuberculosis in which invasion of the peritoneum was verified, for which tetraconjugate treatment was started; however, the patient showed an adverse hepatic reaction and died due to multisystem involvement of a pulmonary infectious complication. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tuberculosis is one of the most important communicable diseases in the world. CLINICAL CASE: A 22-year-old male patient who consulted for a 6-month period of moderate intensity abdominal pain associated with emetic episodes, weight loss, anorexia, asthenia and adynamia. At the physical examination patient had generalized pallor, poor nutritional status, 3 cm ganglion in the left supraclavicular region, tense, painful and palpable abdomen in the epigastrium, flank and right iliac fossa, in addition to the palpable mass in the mesogastrium. The tomography showed abdominal conglomeration, and the biopsy confirmed the presence of resistant alcoholic acid bacilli, thus initiating the management of peritoneal tuberculosis with tetraconjugate. CONCLUSIONS: Only 18% of patients with tuberculosis have extrapulmonary forms. The condition of the peritoneum occurs in only 1 to 3% of cases. There are multiple risk factors that can be associated with the development of this entity, mainly that facilitate immunodeficiency. [ABSTRACT FROM AUTHOR]

Peritoneal tuberculosis is a rare disease that accounts for 25-50% of abdominal tuberculosis cases and 0.1-0.7% of all cases of tuberculosis. Mortality is 35% when treatment is delayed, and 73% in patients with cirrhosis. It also has a wide clinical spectrum, so its differential diagnosis covers conditions such as cirrhosis, malignancy, nephrotic syndrome, and malnutrition. Moreover, imaging studies may reveal peritoneal metastases; carcinomatosis of gastric, pancreatic, bladder, ovarian, colonic origin; and infectious diseases such as actinomycosis, coccidioidomycosis, histoplasmosis or non-tuberculous mycobacteria. Diagnosis is initially supported by blood chemistry, liver and renal function tests, ultrasound, CT scans, paracentesis with peritoneal fluid cytochemistry, and ADA and PCR measurement. The gold standard is laparoscopy with peritoneal biopsy and pathological or microbiological confirmation. Cases of false negatives of the ADA test have been described in immunosuppression or use of antituberculosis drugs. Monitoring of disease activity by measuring CA-125 levels has been considered. The following is the report of an unusual case of peritoneal TB with secondary Sweet's syndrome, in which the ADA report was initially negative, possibly due to meropenem administration, and in whom disease activity was monitored through Ca125. False negative reports of ADA and Sweet's secondary to TB are very rare, so this case contributes to the literature on these conditions. [ABSTRACT FROM AUTHOR]

Nowadays, peritoneal tuberculosis is an entity that has been overdiagnosed in many instances of health, not only in Mexico, it is sufficient to note in the literature that this situation is still manifest. In addition, this entity proves to be difficult to diagnose without proper interrogation, as well as adequate cabinet and laboratory diagnostic tools. Therefore, the need arises to carry out an adequate interrogation when the symptoms are clear about the entity treated. However, it should be noted that Mexico is a country in which there are still abundant cases of tuberculosis, so timely diagnosis improves not only the survival, but also the quality of life these patients come to have after their illness. [ABSTRACT FROM AUTHOR]

Peritoneal tuberculosis occurs in less than 3% of cases of peritonitis associated with dialysis. It is a complex picture characterized by refractory ascites, abdominal distension, abdominal pain and fever. We present the case of a male patient with chronic renal failure in renal replacement therapy with peritoneal dialysis who was diagnosed with peritoneal tuberculosis. Clinical and imaging evidence for the diagnosis of the disease are highlighted. [ABSTRACT FROM AUTHOR]

This is a case study of a 69 year old immunosuppressed man with renal failure who was on hemodialysis. He developed chronic abdominal pain and acute diarrhea that progressed to intestinal obstruction. Diagnostic laparoscopy reported peritoneal carcinomatosis, but histological diagnosis showed that it was peritoneal tuberculosis. [ABSTRACT FROM AUTHOR]

Background: Peritoneal tuberculosis is usually secondary to a primary pulmonary infection that disseminates through lymph or blood. The clinical picture can mimic ovarian cancer because of its vague symptoms and unspecific signs, such as an adnexal mass, ascites or an elevated CA 125 serum level. Clinical case: The patient was a 24-year-old woman with weight loss, a pleural effusion, abdominal distension, and an elevated CA 125 level. Transoperative findings were ascites, an ovarian mass, and the presence of peritoneal nodules. The pathological study of the omentum and adnexal biopsy reported tuberculosis, and antituberculosis treatment was given. Conclusion: Peritoneal tuberculosis is difficult to diagnose, it usually requires pathological studies and bacterial cultures obtained by biopsy to confirm it. With early treatment, it usually has a good prognosis. [ABSTRACT FROM AUTHOR]