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1
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Xing Y, Jiang X, Li X, Li X, Liu H. Challenges in diagnosing pseudomyxoma peritonei in a hepatitis B patient: A case report. Medicine (Baltimore) 2025; 104:e42298. [PMID: 40295254 PMCID: PMC12039974 DOI: 10.1097/md.0000000000042298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 04/07/2025] [Accepted: 04/10/2025] [Indexed: 04/30/2025] Open
Abstract
RATIONALE Pseudomyxoma peritonei (PMP) is a rare condition, typically associated with the rupture of an appendiceal mucinous tumor. Due to its rarity and the complexity of its pathophysiology, PMP presents a significant diagnostic challenge. PATIENT CONCERNS A 59-year-old woman presented with a 6-month history of abdominal distension, anorexia, and significant weight loss. Her medical history was notable for chronic hepatitis B. She was initially treated for suspected cirrhosis, but her symptoms did not improve and therefore further diagnostic evaluation was needed. DIAGNOSIS Initial imaging, including liver magnetic resonance imaging (MRI) and abdominal ultrasound, showed irregular liver margins and ascites, consistent with cirrhosis. However, subsequent diagnostic tests, including uterine MRI, positron emission tomography-computed tomography, and abdominal ultrasound, revealed features suggestive of PMP. Immunohistochemistry and histopathological examination of tissue samples confirmed low-grade mucinous adenocarcinoma of gastrointestinal origin, specifically from the appendix. INTERVENTIONS The patient underwent cytoreductive surgery, and postoperative pathology confirmed mucinous adenocarcinoma originating from the appendix. The patient was also treated with intraperitoneal hyperthermic chemotherapy. OUTCOME The final diagnosis was PMP. LESSONS This case illustrates a rare presentation of PMP in a patient with co-existing hepatitis B, in which the initial diagnosis was biased towards cirrhosis: a more common cause of ascites in hepatitis B patients. This case highlights the importance of considering PMP in the differential diagnosis for patients presenting with unexplained ascites and abdominal distension.
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Affiliation(s)
- Yan Xing
- Department of Ultrasound, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Xuguang Jiang
- Department of Ultrasound, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Xiang Li
- Department of Imaging, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Xuan Li
- Department of Imaging, Zaozhuang Municipal Hospital, Zaozhuang, China
| | - Haifeng Liu
- Department of Ultrasound, Zaozhuang Municipal Hospital, Zaozhuang, China
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2
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Sampath A, Mani S. Diagnostic evaluation and management of abdominal tuberculosis. Indian J Tuberc 2025; 72 Suppl 1:S7-S11. [PMID: 40023548 DOI: 10.1016/j.ijtb.2025.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 01/03/2025] [Accepted: 02/07/2025] [Indexed: 03/04/2025]
Abstract
Abdominal Tuberculosis represents 11-16% of extrapulmonary tuberculosis and usually presents with vague abdominal symptoms that can mimic other diseases such as inflammatory bowel disorders, malignancy and sarcoidosis. Often the diagnosis is delayed and complications such as adhesions, obstruction, fistula or bleeding can occur. The common types are peritoneal and intestinal TB. Clinical findings should be complemented with appropriate imaging techniques such as ultrasound, CT/MRI scan, barium roentgenograms and endoscopy. Due to the paucibacillary nature, the sensitivity of AFB smear, culture, PCR assays are usually lower and interventional procedures such as endoscopy/laparoscopic biopsy should be promptly utilized wherever needed so as to initiate early treatment and avoid late complications. Standard anti-TB regimen (2RHZE/4RHE) usually achieve higher cure rates in drug sensitive TB. Close follow-up monitoring is needed to evaluate the effectiveness of proper and regular treatment. Endoscopic interventions or surgery may be required in managing complications.
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Affiliation(s)
- Arun Sampath
- Department of Pulmonary & Sleep Medicine, MIOT International, Chennai, India.
| | - Saravanan Mani
- Department of Respiratory Medicine, Stanley Medical College, Chennai, India.
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3
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Nazaré P, Vale F, Carneiro L, Tomé A, Gomes I. Peritoneal Tuberculosis and the Associated Diagnostic Challenges in Gynecology: A Case Report. Cureus 2025; 17:e77250. [PMID: 39925595 PMCID: PMC11807723 DOI: 10.7759/cureus.77250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2025] [Indexed: 02/11/2025] Open
Abstract
Peritoneal tuberculosis should be considered in young patients presenting with non-specific abdominal pain, constitutional symptoms and ascites. Here, we describe a case of a 29-year-old woman with pelvic pain, abdominal distension and weight loss. She presented with a distended, painful abdomen, and painful mobilization of the uterus and adnexa. Imaging revealed multiloculated adnexal formations, ascites and peritoneal thickening. A diagnostic laparoscopy was performed, with findings suggestive of peritoneal carcinomatosis, but the biopsies were compatible with granulomatous peritonitis. The definitive diagnosis was confirmed by cultural growth of Mycobacterium tuberculosis, so the patient started antituberculosis treatment. This case illustrates the difficulty in establishing the differential diagnosis between peritoneal carcinomatosis and granulomatous peritonitis.
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Affiliation(s)
- Patrícia Nazaré
- Gynecology and Obstetrics, Hospital Garcia de Orta, Almada, PRT
| | - Francisco Vale
- Infectious Diseases, Hospital Garcia de Orta, Almada, PRT
| | - Leonardo Carneiro
- Pathology and Laboratory Medicine, Hospital Garcia de Orta, Almada, PRT
| | - Ana Tomé
- Gynecology and Obstetrics, Hospital Garcia de Orta, Almada, PRT
| | - Inês Gomes
- Gynecology and Obstetrics, Hospital Garcia de Orta, Almada, PRT
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4
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Barchid A, Fadil W, Ahallat A, Aggouri Y, Aitlaalim S. Cocoon Syndrome: A Rare Cause of Bowel Obstruction Revealing Hidden Intestinal Tuberculosis. Cureus 2025; 17:e77090. [PMID: 39917142 PMCID: PMC11801809 DOI: 10.7759/cureus.77090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2025] [Indexed: 02/09/2025] Open
Abstract
Abdominal cocoon syndrome, also known as sclerosing encapsulating peritonitis (SEP), is characterized by the entrapment of intestinal loops by a fibrous membrane and is a rare cause of small bowel obstruction. We report a rare case of SEP secondary to intestinal tuberculosis in a 35-year-old male patient with no relevant medical history. He presented with symptoms suggestive of bowel obstruction, including acute abdominal pain, vomiting, and abdominal distension. Imaging showed pneumoperitoneum and encapsulation of the small intestine, while surgery revealed a fibrous capsule surrounding the bowel. Histopathological examination confirmed intestinal tuberculosis with granulomatous inflammation and caseating necrosis. Treatment involved surgical resection, ileostomy, and antitubercular therapy. This case emphasizes the importance of considering abdominal tuberculosis in the differential diagnosis of SEP.
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Affiliation(s)
- Anass Barchid
- General Surgery, Tangier University Hospital, Abdelmale Essaadi University, Faculty of Medicine, Tangier, MAR
| | - Walid Fadil
- General Surgery, University Hospital Center, Tangier, MAR
| | - Anas Ahallat
- General Surgery, University Hospital Mohammed VI, Tangier, MAR
| | - Younes Aggouri
- General Surgery, Tangier University Hospital, Abdelmale Essaadi University, Faculty of Medicine, Tangier, MAR
| | - Said Aitlaalim
- General Surgery, Tangier University Hospital, Abdelmale Essaadi University, Faculty of Medicine, Tangier, MAR
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5
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Al-Zughali EA, Al-Shami NA, Hamedat AW, Al-Bustanji S, Almaletti M, Al-Shaibani EM, Ba-Shammakh SA. Peritoneal Tuberculosis Mimicking Ovarian Malignancy: A Case Report. Cureus 2024; 16:e76231. [PMID: 39845238 PMCID: PMC11751587 DOI: 10.7759/cureus.76231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2024] [Indexed: 01/24/2025] Open
Abstract
Peritoneal tuberculosis (TB) is a rare extrapulmonary form of TB that often mimics ovarian malignancy, posing diagnostic challenges. This report presents a 16-year-old Jordanian female with abdominal distension, weakness, anorexia, and night sweats. Initial imaging, including contrast-enhanced computed tomography (CT), revealed compartmentalized ascites, peritoneal thickening, and enlarged ovaries with masses, suggesting possible ovarian malignancy. Laboratory findings showed elevated C-reactive protein (CRP) and cancer antigen 125 (CA-125) levels. The ascitic fluid analysis demonstrated high protein content with a neutrophil predominance, while pelvic magnetic resonance imaging (MRI) suggested tuberculous peritonitis. Exploratory laparotomy identified intra-abdominal adhesions, omental nodules, and a thickened peritoneum. Histopathology confirmed TB through granulomatous inflammation with caseating granulomas. This case underscores the importance of including TB in the differential diagnosis of ovarian malignancy, especially in TB-endemic areas, and highlights the role of early diagnosis and multidisciplinary management.
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Affiliation(s)
| | | | - Anas W Hamedat
- Department of Internal Medicine, The Islamic Hospital, Amman, JOR
| | - Salwa Al-Bustanji
- Department of Gastroenterology and Hepatology, The Islamic Hospital, Amman, JOR
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6
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Correia IM, Costa R, Madeira JIM, Fonseca I. Peritoneal tuberculosis: the diagnostic challenge must not preclude treatment. BMJ Case Rep 2024; 17:e263066. [PMID: 39537392 DOI: 10.1136/bcr-2024-263066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024] Open
Abstract
Peritoneal tuberculosis (TB) is a rare extrapulmonary infection caused by Mycobacterium tuberculosis It is mainly found in countries with a high burden of TB, so travelling from an endemic area should raise suspicion. Although it is a well-recognised disease, it remains a challenge due to its difficult clinical and microbiological diagnosis. This can lead to a delay, both in diagnosis and treatment with serious prognostic implications. We describe the case of a woman in her mid-50s who presented with fever, abdominal pain, vomiting, breathlessness, anorexia and weight loss. On physical examination, she had decreased breath sounds at the right lung and clinical ascites. Blood tests revealed elevated inflammatory markers and anaemia. Imaging showed ascites, enhanced peritoneal thickening, densification of the mesenteric fat and right pleural effusion. After paracentesis, diagnostic thoracotomy and laparoscopy were undertaken. Based on a presumptive diagnosis, treatment was started. M. tuberculosis was lastly isolated in ascitic fluid culture after 6 weeks. The patient completed a 6-month course of anti-TB drugs with a favourable outcome.
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Affiliation(s)
| | - Regina Costa
- Internal Medicine Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | | | - Isabel Fonseca
- Internal Medicine Department, Coimbra University Hospital Centre, Coimbra, Portugal
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7
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Flores RM, Dopp M, Bhatt VV, Theodory B, Robb PM. A rare case of peritoneal tuberculosis mimicking peritoneal carcinomatosis: the ongoing challenge. BMC Infect Dis 2024; 24:1140. [PMID: 39390402 PMCID: PMC11468269 DOI: 10.1186/s12879-024-10028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/01/2024] [Indexed: 10/12/2024] Open
Abstract
Tuberculosis (TB) is a serious infection that can involve any organ system and present in various forms. About one-third of the world's population are carriers of latent TB. Although most cases are from a pulmonary origin, there is a rising prevalence of abdominal TB. Patients with pulmonary or extrapulmonary TB are treated similarly through the use of pharmacological therapy. Nonspecific clinical manifestations of TB have made it difficult for clinicians to diagnose. Peritoneal tuberculosis (PTB) is a serious concern as its symptoms overlap with that of many other chronic conditions, especially in those who are immunocompromised. The lack of highly sensitive and specific testing methods has made early intervention difficult, therefore a high index of suspicion is crucial in the progression of the disease. Here, we present a case of a 71-year-old female with a history of abdominal pain, fever, and weakness. Initial investigation with computed tomography (CT) imaging revealed omental fat stranding that pointed towards peritoneal carcinomatosis (PC) from possible recurrence of her ovarian cancer. Further investigation with a peritoneal biopsy was remarkable for caseating granulomas with fat necrosis confirming extrapulmonary TB. This report highlights a rare case of PTB mimicking PC in an elderly patient who is immunocompromised from the use of long-term corticosteroids who continued to decline after pharmacological treatment of the disease.
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Affiliation(s)
- Roberto M Flores
- University of California, Riverside School of Medicine, Inland Empire, CA, USA
| | - Meena Dopp
- Department of Internal Medicine, Kaiser Permanente, 9961 Sierra Ave, Fontana, Inland Empire, CA, 92395, USA
| | - Vivek V Bhatt
- University of California, Riverside School of Medicine, Inland Empire, CA, USA
| | - Bassam Theodory
- University of California, Riverside School of Medicine, Inland Empire, CA, USA
| | - Paul M Robb
- Department of Internal Medicine, Kaiser Permanente, 9961 Sierra Ave, Fontana, Inland Empire, CA, 92395, USA.
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8
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Minani JB, Bisimwa W, Cikomola Gulimwentuga F, Bedha A, Maheshe Balemba G, Mateso Mbale GQ, Lupande Mwenebitu D, Mulumeoderhwa Kahasha P, Baguma M, Mwene-Batu P, Katoto PD, Shindano TA. Atypical tuberculous peritonitis presenting as a peritoneal pseudocyst in an immunocompetent adult: insights from a case and literature review. BMC Infect Dis 2024; 24:1077. [PMID: 39350023 PMCID: PMC11441176 DOI: 10.1186/s12879-024-09955-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 09/18/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Tuberculous peritonitis often presents with nonspecific symptoms that can lead to diagnostic challenges, particularly when manifesting as peritoneal pseudocysts. This study highlights the clinical complexity and diagnostic approach of tuberculous peritonitis presented as a pseudocyst in an immunocompetent adult, an atypical scenario that is rarely documented. CASE PRESENTATION We report a detailed case of a 41-year-old man presenting with abdominal distension, pain, and significant weight loss over four months. Abdominal CT showed a peritoneal pseudocyst, initially misdiagnosed due to its resemblance to more common abdominal pathologies. The diagnosis of tuberculous peritonitis was confirmed through histopathological analysis. Additionally, a systematic literature review was conducted to identify and analyse similar cases, focusing on clinical presentations, diagnostic methods, and patient outcomes. Our patient exhibited classic symptoms of abdominal TB but was unique due to the absence of prior ventriculoperitoneal shunting, a common factor in similar cases. Our literature review found that such presentations typically result in diagnostic delays averaging five months, complicating patient management and outcomes. This review also underscores the importance of considering tuberculosis in the differential diagnosis of peritoneal pseudocysts, particularly in TB-endemic regions. CONCLUSION This case and review emphasize the need for high clinical suspicion and prompt investigation of tuberculosis in patients presenting with atypical abdominal symptoms and pseudocysts. Improved diagnostic strategies, including early use of imaging and pathological evaluations, are essential for timely diagnosis and management, thereby improving patient outcomes in suspected cases of extrapulmonary tuberculosis.
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Affiliation(s)
- Jimmy Balibanga Minani
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo.
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo.
| | - Wani Bisimwa
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Surgery, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Fabrice Cikomola Gulimwentuga
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Surgery, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Tropical Diseases and Global Health, Department of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Aline Bedha
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Ghislain Maheshe Balemba
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Radiology, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Guy-Quesney Mateso Mbale
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Intensive Care Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - David Lupande Mwenebitu
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Tropical Diseases and Global Health, Department of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Laboratory, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Pierrot Mulumeoderhwa Kahasha
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Department of Pathology, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Marius Baguma
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Tropical Diseases and Global Health, Department of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Pacifique Mwene-Batu
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
| | - Patrick Dmc Katoto
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Tropical Diseases and Global Health, Department of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Evidence Based Medicine, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tony Akilimali Shindano
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, South Kivu, Democratic Republic of the Congo
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
- Centre for Tropical Diseases and Global Health, Department of Medicine, Université Catholique de Bukavu (UCB), Bukavu, South Kivu, Democratic Republic of the Congo
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Liu WP, Ma FZ, Zhao Z, Li ZR, Hu BG, Yang T. Tuberculous peritonitis complicated by an intraperitoneal tuberculous abscess: A case report. World J Clin Cases 2024; 12:6117-6123. [PMID: 39328861 PMCID: PMC11326109 DOI: 10.12998/wjcc.v12.i27.6117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/01/2024] [Accepted: 07/15/2024] [Indexed: 07/29/2024] Open
Abstract
BACKGROUND Tuberculous peritonitis (TBP) is a chronic, diffuse inflammation of the peritoneum caused by Mycobacterium tuberculosis. The route of infection can be by direct spread of intraperitoneal tuberculosis (TB) or by hematogenous dissemination. The former is more common, such as intestinal TB, mesenteric lymphatic TB, fallopian tube TB, etc., and can be the direct primary lesion of the disease. CASE SUMMARY We present an older male patient with TBP complicated by an abdominal mass. The patient's preoperative symptoms, signs and imaging data suggested a possible abdominal tumor. After surgical treatment, the patient's primary diagnosis of TBP complicating an intraperitoneal tuberculous abscess was established by combining past medical history, postoperative pathology, and positive results of TB-related laboratory tests. The patient's symptoms were significantly reduced after surgical treatment, and he was discharged from the hospital with instructions to continue treatment at a TB specialist hospital and to undergo anti-TB treatment if necessary. CONCLUSION This case report analyses the management of TBP complicated by intraperitoneal tuberculous abscess and highlights the importance of early definitive diagnosis in the hope of improving the clinical management of this type of disease.
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Affiliation(s)
- Wei-Peng Liu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Feng-Zhen Ma
- Department of Gastroenterology, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Zhou Zhao
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Zong-Rui Li
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Bao-Guang Hu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
| | - Tao Yang
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
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10
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Xu RF, Gao WN, Hu TL, Wang XF, Zhao JR, Meng Y. Pathogenic microorganism DNA high-throughput genetic sequencing to diagnose peritoneal dialysis-associated peritonitis due to Mycobacterium tuberculosis infection. BMC Nephrol 2024; 25:290. [PMID: 39227867 PMCID: PMC11373123 DOI: 10.1186/s12882-024-03727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 08/23/2024] [Indexed: 09/05/2024] Open
Abstract
Peritoneal dialysis-associated peritonitis is a serious complication of peritoneal dialysis, and the prevention and treatment of this condition are important for improving the long-term survival and quality of life of patients. However, peritoneal dialysis-associated peritonitis due to Mycobacterium tuberculosis infection is relatively rare and not easily diagnosed. Here, we present a case of peritoneal dialysis-associated peritonitis caused by Mycobacterium tuberculosis identified by pathogenic microbial DNA high-throughput genetic sequencing. This case demonstrates that pathogenic microbial DNA high-throughput genetic sequencing could be used to improve the detection rate of pathogenic microorganisms in patients with complex conditions, thereby allowing for earlier initiation of treatment.
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Affiliation(s)
- Rui-Feng Xu
- Department of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, Inner Mongolia, PR China
| | - Wu-Niri Gao
- Department of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, Inner Mongolia, PR China
| | - Ta-la Hu
- Department of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, Inner Mongolia, PR China
| | - Xi-Feng Wang
- Department of Nephrology, No. 2 Hospital of Hohhot, Hohhot, PR China
| | - Jian-Rong Zhao
- Department of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, Inner Mongolia, PR China
| | - Yan Meng
- Department of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, Inner Mongolia, PR China.
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11
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Yamada K, Aoki K, Tanaka R, Matsushima S, Sato A, Kobayashi T, Moody S, Nogi M. On the fence: Combining multimodal imaging and laparoscopy for diagnosing tuberculous peritonitis. Clin Case Rep 2024; 12:e8996. [PMID: 38845802 PMCID: PMC11154765 DOI: 10.1002/ccr3.8996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
Tuberculous peritonitis (TB peritonitis) is one of the most challenging forms of extrapulmonary TB to diagnose. While tumor markers can be elevated in patients with TB peritonitis, FDG-PET/CT can aid in distinguishing TB peritonitis from malignancies, if an apron-like omentum pattern is seen. Laparoscopy is crucial for accurate and early diagnosis.
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Affiliation(s)
- Kenji Yamada
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
| | - Kazuaki Aoki
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
| | - Rina Tanaka
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
| | - Seito Matsushima
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
| | - Akiyuki Sato
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
| | | | - Sandra Moody
- Department of Medicine, Divisions of Hospital Medicine & GeriatricsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Masayuki Nogi
- Department of General Internal MedicineKameda Medical CenterKamogawa, ChibaJapan
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12
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Chen T, Chen G, Wang G, Treeprasertsuk S, Lesmana CRA, Lin HC, Al-Mahtab M, Chawla YK, Tan SS, Kao JH, Yuen MF, Lee GH, Alcantara-Payawal D, Nakayama N, Abbas Z, Jafri W, Kim DJ, Choudhury A, Mahiwall R, Hou J, Hamid S, Jia J, Bajaj JS, Wang F, Sarin SK, Ning Q. Expert consensus on the diagnosis and treatment of end-stage liver disease complicated by infections. Hepatol Int 2024; 18:817-832. [PMID: 38460060 DOI: 10.1007/s12072-023-10637-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/22/2023] [Indexed: 03/11/2024]
Abstract
End-stage liver disease (ESLD) is a life-threatening clinical syndrome and when complicated with infection the mortality is markedly increased. In patients with ESLD, bacterial or fungal infection can induce or aggravate the occurrence or progression of liver decompensation. Consequently, infections are among the most common complications of disease deterioration. There is an overwhelming need for standardized protocols for early diagnosis and appropriate management for patients with ESLD complicated by infections. Asia Pacific region has the largest number of ESLD patients, due to hepatitis B and the growing population of alcohol and NAFLD. Concomitant infections not only add to organ failure and high mortality but also to financial and healthcare burdens. This consensus document assembled up-to-date knowledge and experience from colleagues across the Asia-Pacific region, providing data on the principles as well as evidence-based current working protocols and practices for the diagnosis and treatment of patients with ESLD complicated by infections.
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Affiliation(s)
- Tao Chen
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, P.R. China
| | - Guang Chen
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, P.R. China
| | - Guiqiang Wang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing, China
| | - Sombat Treeprasertsuk
- Department of Medicine, Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, and Thai Red Cross, Bangkok, Thailand
| | - Cosmas Rinaldi Adithya Lesmana
- Internal Medicine, Hepatobiliary Division, Dr. Captor Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, DKI, Indonesia
| | - Han-Chieh Lin
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mamun Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Yogesh K Chawla
- Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | - Soek-Siam Tan
- Department of Hepatology, Hospital Selayang, Selangor Darul Ehsan, Malaysia
| | - Jia-Horng Kao
- Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Man-Fung Yuen
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Guan-Huei Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | | | - Nobuaki Nakayama
- Department of Gastroenterology & Hepatology, Saitama Medical University, Saitama, Japan
| | - Zaigham Abbas
- Department of Medicine, Ziauddin University Hospital, Karachi, Pakistan
| | - Wasim Jafri
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Dong-Joon Kim
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital of Hallym University Medical Center, Chuncheon, Korea
| | - Ashok Choudhury
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rakhi Mahiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jinlin Hou
- Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Saeed Hamid
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - J S Bajaj
- Department of Medicine, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, VA, USA
| | - Fusheng Wang
- Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing, China
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Qin Ning
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, P.R. China.
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13
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Laamara L, Benaissa E, Achemlal A, Bounakhla A, Bssaibis F, BenLahlou Y, Maleb A, Chadli M, Elouennass M. Peritoneal tuberculosis, an underestimated diagnosis: a case report. Access Microbiol 2024; 6:000753.v3. [PMID: 38868373 PMCID: PMC11165665 DOI: 10.1099/acmi.0.000753.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/02/2024] [Indexed: 06/14/2024] Open
Abstract
Tuberculosis is an infectious disease that most often affects the lungs, caused by human-to-human transmission of Mycobacterium tuberculosis. Peritoneal tuberculosis is an extra-pulmonary form of the disease that usually manifests as an ascitic syndrome, with or without fever, in a context of altered general condition, often in endemic areas. The diagnosis of peritoneal tuberculosis is not always easy, as the clinical signs are often insidious and unspecific. We report a case of peritoneal tuberculosis in an 18-year-old female, who had presented for 10 days with a progressive increase in abdominal volume associated with vomiting and diarrhoea.
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Affiliation(s)
- Leila Laamara
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Elmostafa Benaissa
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Amine Achemlal
- Gastroenterology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Amal Bounakhla
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Fatna Bssaibis
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Yassine BenLahlou
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Adil Maleb
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mariama Chadli
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mostafa Elouennass
- Bacteriology Department, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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14
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Oppong B, Gyabaah S, Amponsah GM, Quansah A, Darkwa EA. Peritoneal tuberculosis masquerading as an ovarian malignancy in a young female: A case report. Clin Case Rep 2024; 12:e8617. [PMID: 38464570 PMCID: PMC10923695 DOI: 10.1002/ccr3.8617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/01/2024] [Accepted: 02/10/2024] [Indexed: 03/12/2024] Open
Abstract
The clinical manifestations of peritoneal tuberculosis are quite variable, nonspecific and mimic many diseases and pathological conditions such as lymphoma, and ovarian malignancy. Due to this clinical overlap and limited accuracy of diagnostic tests, more awareness of this disease is required to enable early diagnosis and prompt treatment. This is a case of a 25-year-old female with no known chronic illness who presented with worsening generalized abdominal pains and distension of 2 months duration. There was an associated significant weight loss of 17 kg. She was initially diagnosed with ovarian malignancy based of ultrasound findings and elevated CA-125 levels. However, further evaluation later was consistent with peritoneal tuberculosis for which she was treated. Her symptoms resolved completely after 6 months of anti-tuberculosis treatment. Diagnosis of abdominal TB remains challenging as it is non-specific. Its features and clinical manifestation overlap with other conditions such as ovarian malignancy. A high index of suspicions and judicious application of the available diagnostic test is need for prompt diagnosis. No single test can effectively diagnose peritoneal TB, but a combination of history, and radiological, immunologic, molecular, and cytologic tests are important.
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Affiliation(s)
- Bright Oppong
- Komfo Anokye Teaching HospitalKumasiGhana
- School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | | | - Gorden Manu Amponsah
- Komfo Anokye Teaching HospitalKumasiGhana
- School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ato Quansah
- Komfo Anokye Teaching HospitalKumasiGhana
- School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
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15
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Nonaka M, Ishida H, Manrai M, Takashima A. Tuberculous peritonitis diagnosed following laparoscopic examination for suspected advanced ovarian cancer. BMJ Case Rep 2024; 17:e257973. [PMID: 38429060 PMCID: PMC10910656 DOI: 10.1136/bcr-2023-257973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
Laparoscopy for intra-abdominal exploration and tissue sampling is useful in advanced ovarian cancers, in which it is presumed to be difficult to achieve complete tumour reduction in the initial surgery. This is a report of a case of suspected advanced ovarian cancer in a patient, who underwent laparoscopic screening and was later pathologically diagnosed with tuberculous peritonitis. A woman in her 50s visited her local doctor with constipation. Since imaging showed massive ascites she was referred for further evaluation. We initially suspected advanced ovarian cancer due to the presence of massive ascites and multiple peritoneal nodules. However, histopathological examination indicated that the nodules were tubercles, and the patient was subsequently diagnosed with tuberculous peritonitis. It is important to be aware that tuberculosis peritonitis can be misdiagnosed or mistaken for advanced ovarian cancer. Preoperative diagnosis of tuberculous peritonitis is often difficult. Tuberculous peritonitis should be considered if intraoperative findings show diffuse nodular disseminated lesions.
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Affiliation(s)
- Mizuki Nonaka
- Department of Obstetrics and Gynecology, Toho University Medical Center, Sakura, Japan
| | - Hiroaki Ishida
- Department of Obstetrics and Gynecology, Toho University Medical Center, Sakura, Japan
| | - Megumi Manrai
- Department of Obstetrics and Gynecology, Toho University Medical Center, Sakura, Japan
| | - Akiko Takashima
- Department of Obstetrics and Gynecology, Toho University Medical Center, Sakura, Japan
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16
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Verma R, Sonier C, Rizvi N, Kashyap R. Multi-Drug-Resistant Tuberculosis Peritonitis: A Case Report. Cureus 2024; 16:e53975. [PMID: 38469015 PMCID: PMC10927249 DOI: 10.7759/cureus.53975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2024] [Indexed: 03/13/2024] Open
Abstract
The increasing incidence of tuberculosis raises concerns globally, impacting both developing and developed nations. Abdominal tuberculosis stands out as the most prevalent form of extrapulmonary tuberculosis. This case report details the diagnostic journey of a young male with abdominal TB complicated by concurrent HIV infection. The patient presented with night sweats and substantial weight loss, concurrently receiving a naive human immunodeficiency virus (HIV) diagnosis with an undetectable CD4 count. Imaging revealed abdominal lymphadenopathy concealing the pancreatic head while bronchoscopy unveiled TB in the lung. The patient faced septic shock and bilateral pulmonary embolism, possibly due to immune reconstitution inflammatory syndrome (IRIS). The patient then developed ascites, and a diagnosis of TB peritonitis was made based on low serum ascites albumin gradient (SAAG) and a positive acid-fast bacillus (AFB) result in the para-aortic lymph node. Treatment complexity arose from drug resistance to isoniazid and ethambutol.
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Affiliation(s)
- Rhea Verma
- Medicine, Drexel University College of Medicine, Philadelphia, USA
| | | | - Nida Rizvi
- Internal Medicine, WellSpan Health, York, USA
| | - Rahul Kashyap
- Medicine, Drexel University College of Medicine, Philadelphia, USA
- Research, Global Remote Research Program, St Paul, USA
- Critical Care Medicine, Mayo Clinic, Rochester, USA
- Research, WellSpan Health, York, USA
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17
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Tong CW, Sarofim M, Wijayawardana R, Morris DL. Peritoneal Tuberculosis in Western Countries: A Rare Case With Concurrent Helminthic Infection. Cureus 2024; 16:e54438. [PMID: 38380110 PMCID: PMC10877224 DOI: 10.7759/cureus.54438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 02/22/2024] Open
Abstract
This case report presents a rare case of peritoneal tuberculosis (TB) coexisting with a helminthic infection in a 25-year-old female residing in Australia, highlighting the diagnostic challenges posed by abdominal TB. Despite the low incidence of TB in Western countries, abdominal TB remains a diagnostic dilemma due to its nonspecific symptoms and potential mimicry of other abdominal pathologies. The case highlights the importance of considering TB as a differential diagnosis of unexplained abdominal symptoms, particularly in individuals with a history of travel or previous residence in high-endemic regions. A multidisciplinary approach involving infectious disease specialists, radiologists, and surgeons is essential for comprehensive management. Prompt initiation of anti-TB therapy is recommended once diagnosis is confirmed.
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Affiliation(s)
- Chai Wei Tong
- Surgery, St George Hospital, Kogarah, AUS
- School of Medicine, University of New South Wales, Sydney, AUS
| | - Mina Sarofim
- Surgery, St George Hospital, Kogarah, AUS
- School of Medicine, University of New South Wales, Sydney, AUS
| | - Ruwanthi Wijayawardana
- Surgery, St George Hospital, Kogarah, AUS
- School of Medicine, University of New South Wales, Sydney, AUS
| | - David L Morris
- Surgery, St George Hospital, Kogarah, AUS
- School of Medicine, University of New South Wales, Sydney, AUS
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18
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Wang C, Zou RQ, He GZ. Progress in mechanism-based diagnosis and treatment of tuberculosis comorbid with tumor. Front Immunol 2024; 15:1344821. [PMID: 38298194 PMCID: PMC10827852 DOI: 10.3389/fimmu.2024.1344821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
Tuberculosis (TB) and tumor, with similarities in immune response and pathogenesis, are diseases that are prone to produce autoimmune stress response to the host immune system. With a symbiotic relationship between the two, TB can facilitate the occurrence and development of tumors, while tumor causes TB reactivation. In this review, we systematically sorted out the incidence trends and influencing factors of TB and tumor, focusing on the potential pathogenesis of TB and tumor, to provide a pathway for the co-pathogenesis of TB comorbid with tumor (TCWT). Based on this, we summarized the latest progress in the diagnosis and treatment of TCWT, and provided ideas for further exploration of clinical trials and new drug development of TCWT.
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Affiliation(s)
- Chuan Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Rong-Qi Zou
- Vice Director of Center of Sports Injury Prevention, Treatment and Rehabilitation China National Institute of Sports Medicine A2 Pangmen, Beijing, China
| | - Guo-Zhong He
- School of Public Health, Kunming Medical University, Kunming, China
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19
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Feng B, Ma Q, Wang H, Zhao T, Tian Y, Dong Y, Zhao Q. A case of peritoneal Burkitt's lymphoma mimic of peritoneal tuberculosis. Respir Med Case Rep 2024; 47:101979. [PMID: 38292731 PMCID: PMC10825563 DOI: 10.1016/j.rmcr.2024.101979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Peritoneal lymphomatosis is a rare presentation of lymphoma that can mimic peritoneal tuberculosis. The computed tomography findings in both conditions include omental caking, thickening, and nodularity. We report the case of a 41-year-old man who presented with intermittent abdominal pain and distension. Abdominal CT initially suggested peritoneal tuberculosis due to the thickening of the peritoneum and greater omentum with multiple nodules. However, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) images showed diffuse metabolic activity increase in the thickened peritoneum, omentum, and mesentery. An omental biopsy was performed under ultrasonography guidance, and histopathological examination revealed a high-grade Burkitt lymphoma. It is crucial to distinguish peritoneal lymphomatosis from tuberculosis, as the prognosis and management of the two conditions are vastly different.
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Affiliation(s)
- Bei Feng
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
| | - Qianfeng Ma
- Department of Ultrasound, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
| | - Huiwei Wang
- Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Haiyuan 1st Road, Futian District, Shenzhen, Guangdong, China
| | - Tingting Zhao
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
| | - Yaxin Tian
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
| | - Yiyuan Dong
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
| | - Qian Zhao
- Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Shengli Street, Yinchuan, 750004, Ningxia, China
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20
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Zengin O, Göre B, Sağlar Y, Şahiner ES, İnan O, Ateş İ. Poncet's disease and tubal tuberculosis: A case report. Int J Rheum Dis 2024; 27:e14883. [PMID: 37602566 DOI: 10.1111/1756-185x.14883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023]
Abstract
A 25-year-old female patient was admitted to the hospital with abdominal pain, loss of appetite, and weight loss for the last 5 months. The patient underwent paracentesis five times and was referred to our clinic after peritonitis findings were detected. Tubal tuberculosis was detected during her hospitalization. The patient, who also developed joint pain, was diagnosed with Poncet's disease. She was given quadruple antituberculosis treatment. After the treatment, the patient's joint pain regressed, and the adnexal mass due to tubal tuberculosis disappeared. In this case report, we wanted to present a rare case of Poncet's disease with tubal tuberculosis.
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Affiliation(s)
- Oğuzhan Zengin
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Burak Göre
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Yunus Sağlar
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | | | - Osman İnan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - İhsan Ateş
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
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21
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Yang TY, Tian YC, Yen TH, Chang MY, Lin CY, Liu SH. Tuberculous peritonitis in patients on peritoneal dialysis: a 35-year experience from a large medical center in Northern Taiwan. Ren Fail 2023; 45:2153064. [PMID: 36632795 PMCID: PMC9848244 DOI: 10.1080/0886022x.2022.2153064] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Tuberculous peritonitis (TBP) is a rare but fatal complication in patients on peritoneal dialysis (PD). In this study, we aimed to determine the demographic features, clinical features, laboratory parameters, and clinical outcomes of PD patients with TBP and to clarify possible risk factors for mortality. MATERIALS AND METHODS We retrospectively reviewed 2084 PD patients from January 1985 to December 2019. The diagnosis of TBP was established by positive peritoneal fluid culture for Mycobacterium tuberculosis. RESULTS 18 patients were diagnosed with TBP. The incidence was 2.029 episodes per 1000 patient-years. The most common symptom was fever (94.4%), followed by cloudy effluent (83.3%) and abdominal pain (83.3%). The average peritoneal dialysis effluent (PDE) white blood cell (WBC) count was 172.7 cells/μL. Nine patients (50%) had WBC counts lower than 100 cells/μL and 13 patients (72.2%) had neutrophilic predominant WBC counts. Acid fast stain (AFS) was positive in 7 patients (38.9%). Only 2 patients (11.1%) continued with PD after TB infection, while 10 patients (55.6%) changed to hemodialysis. Seven patients (38.9%) died within 1 year. Significant differences were observed in sex (p = 0.040), the presence of diabetes mellitus (p = 0.024), and PD catheter removal (p < 0.001) between TBP patients with and without mortality. However, none of them was a significant factor for 1-year mortality in multivariate Cox regression model. CONCLUSION Physicians should pay attention to the unusual presentations of peritonitis, especially if symptoms include fever or an initial low PDE WBC count. Catheter removal is not mandatory if early diagnosis and appropriate therapy are available.
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Affiliation(s)
- Tzu-Yi Yang
- Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Chung Tian
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Yang Chang
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chan-Yu Lin
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shou-Hsuan Liu
- Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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22
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Wang P, Feng Y, Qi H, Feng H, Chen Y, Zeng G, Dai W. Diagnostic value of serum CA125 combined with PET/CT in ovarian cancer and tuberculous peritonitis in female patients. Abdom Radiol (NY) 2023; 48:3449-3457. [PMID: 37493838 DOI: 10.1007/s00261-023-03997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE To evaluate the diagnostic value of serum CA125 combined with 18F-FDG PET/CT in ovarian cancer (OC) and tuberculous peritonitis (TBP) in female patients and to establish a diagnostic scoring system. METHOD A total of 86 female patients (64 OC and 22 TBP) were included in this study. Serum CA125, PET/CT maximal intensity projection (MIP), maximal standardized uptake value, ovarian mass, ascites volume, and other indicators were analyzed and a diagnostic scoring system was established according to the weights of statistically significant indicators. RESULTS Univariate analysis showed that serum CA125 in OC and TBP patients were 2079.9 ± 1651.3 U/mL and 448.3 ± 349.5 U/mL (P < 0.001). In MIP images, abdominal lesions were focal distribution in 92.2% (59/64) of OC patients and diffuse distribution in 95.5% (21/22) of TBP patients (P < 0.001). Ovarian masses could be observed in 82.8% (53/64) OC patients and 31.8% (7/22) TBP patients (P <0.001). The other indicators were not statistically significant. Logistic regression analysis showed that serum CA125 and MIP were independent risk factors for diagnosis. A diagnostic scoring system could be established based on serum CA125, MIP and ovarian mass, and the diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 98.4% (63/64), 95.5% (21/22), 97.7% (84/86), 98.4% (63/64), and 95.5% (21/22), respectively. CONCLUSION Serum CA125 combined with PET/CT is of great value in the diagnosis of OC and TBP. A simple and efficient diagnostic scoring system can be established using serum CA125, MIP image feature, and ovarian mass.
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Affiliation(s)
- Peng Wang
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Yawen Feng
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Hongyan Qi
- Department of Ultrasound, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
| | - Hui Feng
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Yuqi Chen
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Guoliang Zeng
- Zhijiang People's Hospital, Yichang, Hubei, PR China.
| | - Wenli Dai
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China.
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China.
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23
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Frankovitz JH, Penny KW, Barnard DL. Peritoneal Tuberculosis in a Middle-Aged Man. Am Surg 2023; 89:4863-4865. [PMID: 33847174 DOI: 10.1177/00031348211011117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jacob H Frankovitz
- Lincoln Memorial University Debusk College of Osteopathic Medicine, Harrogate, TN, USA
| | - Kyle W Penny
- Lincoln Memorial University Debusk College of Osteopathic Medicine, Harrogate, TN, USA
| | - Danielle L Barnard
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
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24
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Brehm TT, Terhalle E. [Extrapulmonary tuberculosis]. Dtsch Med Wochenschr 2023; 148:1242-1249. [PMID: 37793616 DOI: 10.1055/a-1937-8186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Extrapulmonary tuberculosis (TB) presents unique diagnostic and therapeutic challenges. The site of involvement can vary widely, with common sites including the lymph nodes, pleura, skin, ear, nose and throat, genitourinary system, pericardium, gastrointestinal tract, bones and joints, and central nervous system. Clinical manifestations of extrapulmonary TB are diverse and often non-specific. Diagnosis is based on a combination of clinical suspicion, imaging, histopathology, and microbiology. Treatment of extrapulmonary TB generally follows similar principles to pulmonary TB, but the duration of treatment depends on the site of involvement and the extent of the disease. Increased awareness among healthcare providers is essential for the timely recognition and effective management of extrapulmonary TB cases.
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25
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Aoyama S, Yamashita S, Ishizuka K, Katsukura S, Matsuura H, Kato M. Difficulty in diagnosing peritonitis caused by multidrug-resistant tuberculosis. Clin Case Rep 2023; 11:e7759. [PMID: 37655128 PMCID: PMC10465719 DOI: 10.1002/ccr3.7759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 06/21/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023] Open
Abstract
Key Clinical Message The low sensitivity of ascites culture for acid-fast bacilli necessitates a peritoneal biopsy when tuberculous peritonitis is suspected. Findings in the peritoneum on computed tomography may prompt suspicion of tuberculous peritonitis. Abstract A 47-year-old Nigerian man presented with fever, abdominal distention, and weight loss. Abdominal computed tomography revealed massive ascites and peritoneal thickening. Despite failing to culture acid-fast bacilli from ascites, histological examination and culture of peritoneum revealed multidrug-resistant tuberculosis peritonitis. Peritoneal biopsy is mandatory when tuberculosis peritonitis is suspected.
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Affiliation(s)
- Sayaka Aoyama
- Department of Internal Medicine, Mito Kyodo General HospitalUniversity of TsukubaIbarakiJapan
| | - Shun Yamashita
- Department of General MedicineSaga University HospitalSagaJapan
| | - Kosuke Ishizuka
- Department of General MedicineChiba University HospitalChibaJapan
| | - Shinichi Katsukura
- Department of Diagnostic and Generalist MedicineDokkyo Medical University HospitalTochigiJapan
| | - Hiroki Matsuura
- Department of General Internal MedicineOkayama City HospitalOkayamaJapan
| | - Mikiro Kato
- Department of Infectious DiseasesUniversity of TsukubaIbarakiJapan
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26
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Zebarjadi Bagherpour J, Bagherian Lemraski S, Haghbin Toutounchi A, Khoshnoudi H, Aghaei M, Kouchak Hosseini SP. Peritoneal tuberculosis pretending an acute abdomen; a case report and literature review. Int J Surg Case Rep 2023; 109:108507. [PMID: 37463562 PMCID: PMC10439303 DOI: 10.1016/j.ijscr.2023.108507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Peritoneal tuberculosis (PTB) is an infrequent clinical condition that frequently eludes diagnosis. The scarcity of PTB cases underscores the necessity for heightened vigilance within clinical settings to detect its presence. Notably, there has been a noticeable increase in PTB incidence in recent years. Mycobacterium tuberculosis is the causative agent responsible for PTB, affecting multiple gastrointestinal components such as the peritoneum and hepatobiliary system. Peritoneum is a rare site for TB with broad unspecific symptoms. It can be asymptomatic to periodic signs or mimic the positive peritonitis examinations like our case. CASE PRESENTATION We have reported a case of 19-year-old male experiencing progressive abdominal pain. The presence of generalized tenderness and guarding on physical examination prompted us to perform an urgent laparotomy due to suspicion of peritonitis. During the surgery, we observed the peritoneum exhibiting widespread nodularity, resembling a disseminated seeding pattern, along with mild ascites, which raised our suspicion of peritoneal tuberculosis. Subsequently, cytological analysis of the ascitic fluid and histopathological examination of the lesions confirmed our diagnosis of peritoneal TB. CLINICAL DISCUSSION We have shared our experience in facing PTB and reviewed recent papers to find further relevant information. The common presentations, probable causes, the role of imaging in diagnosis and the management are discussed for better management strategy and the best surgical decision. CONCLUSION Peritoneal tuberculosis is a rare condition with challenging diagnosis. Key symptoms include vomiting, abdominal pain, ascites, weight loss, and fever. Prompt recognition and treatment are vital for better outcomes.
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Affiliation(s)
| | | | - Alireza Haghbin Toutounchi
- Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hojatolah Khoshnoudi
- Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Aghaei
- Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed Pedram Kouchak Hosseini
- Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tanoglu A, Erdem H, Friedland JS, Ankaralı H, Garcia-Goez JF, Albayrak A, El-Kholy A, Ceviker SA, Amer F, Erol S, Darazam IA, Rabiei MM, Sarwar MZ, Zeb M, Nawaz H, Ceylan MR, Cernat R, Tasbakan M, Ayoade F, Ruch Y, Tigen ET, Angioni G, Rajani DP, Akhtar N, Surme S, Sengoz G, Karlıdag GE, Marino A, Ripon RK, Çağ Y, Aydın Ö, Akkoyunlu Y, Seyman D, Angamuthu K, Cascio A, Popescu CP, Sirmatel F, Eren E, Dar RE, Munu FU, Tanoglu EG, Echeverry E, Velez JD, Artuk C, Balin SO, Pandya N, Erdem A, Demiray EKD, Aypak A. Clinicopathological profile of peritoneal tuberculosis and a new scoring model for predicting mortality: an international ID-IRI study. Eur J Clin Microbiol Infect Dis 2023:10.1007/s10096-023-04630-9. [PMID: 37318601 DOI: 10.1007/s10096-023-04630-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023]
Abstract
Existing literature about peritoneal tuberculosis (TBP) is relatively insufficient. The majority of reports are from a single center and do not assess predictive factors for mortality. In this international study, we investigated the clinicopathological characteristics of a large series of patients with TBP and determined the key features associated with mortality. TBP patients detected between 2010 and 2022 in 38 medical centers in 13 countries were included in this retrospective cohort. Participating physicians filled out an online questionnaire to report study data. In this study, 208 patients with TBP were included. Mean age of TBP cases was 41.4 ± 17.5 years. One hundred six patients (50.9%) were females. Nineteen patients (9.1%) had HIV infection, 45 (21.6%) had diabetes mellitus, 30 (14.4%) had chronic renal failure, 12 (5.7%) had cirrhosis, 7 (3.3%) had malignancy, and 21 (10.1%) had a history of immunosuppressive medication use. A total of 34 (16.3%) patients died and death was attributable to TBP in all cases. A pioneer mortality predicting model was established and HIV positivity, cirrhosis, abdominal pain, weakness, nausea and vomiting, ascites, isolation of Mycobacterium tuberculosis in peritoneal biopsy samples, TB relapse, advanced age, high serum creatinine and ALT levels, and decreased duration of isoniazid use were significantly related with mortality (p < 0.05). This is the first international study on TBP and is the largest case series to date. We suggest that using the mortality predicting model will allow early identification of high-risk patients likely to die of TBP.
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Affiliation(s)
- Alpaslan Tanoglu
- Department of Internal Medicine and Gastroenterology, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, University of Health Sciences, 34785, Istanbul, Turkey.
| | - Hakan Erdem
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
- MKCC Cardiac Centre, Awali, Bahrain
| | | | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Jose Fernando Garcia-Goez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Ayse Albayrak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sevil Alkan Ceviker
- Department of Infectious Diseases, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Zagazig Faculty of Medicine, Zagazig, Egypt
| | - Serpil Erol
- Department of Infectious Diseases, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | | | | | - Misbah Zeb
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | - Hassan Nawaz
- Department of Infectious Diseases, Mayo Hospital, Lahore, Pakistan
| | | | - Roxana Cernat
- Department of Infectious Diseases, Clinical Hospital for Infectious Diseases, Constanta, Romania
| | - Meltem Tasbakan
- Department of Infectious Diseases, Ege University, Izmir, Turkey
| | - Folusakin Ayoade
- Department of Infectious Diseases, University of Miami, Miami, FL, USA
| | - Yvon Ruch
- Department of Infectious Diseases, Strasbourg University, Strasbourg, France
| | - Elif Tükenmez Tigen
- Department of Infectious Diseases, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Goffredo Angioni
- Department of Infectious Diseases, Hospital SS Trinità, Borgomanero, Italy
| | - Dhanji P Rajani
- Microcare Laboratory & Tuberculosis Research Centre, Surat, Gujarat, India
| | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Serkan Surme
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gonul Sengoz
- Department of Infectious Diseases, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gulden Eser Karlıdag
- Department of Infectious Diseases, Elazig Fethi Sekin City Hospital, University of Health Sciences, Elazig, Turkey
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar Union, Bangladesh
| | - Yasemin Çağ
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Özlem Aydın
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Akkoyunlu
- Department of Infectious Diseases, Bezmialem Vakif University, Istanbul, Turkey
| | - Derya Seyman
- Department of Infectious Diseases, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Kumar Angamuthu
- Department of Infectious Diseases, Almana General Hospitals, Dammam, Saudi Arabia
| | - Antonio Cascio
- Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | - Corneliu Petru Popescu
- Department of Infectious Diseases, Dr. Victor Babes Clinical Hospital of Infectious and Tropical Diseases, Bucharest, Romania
| | - Fatma Sirmatel
- Department of Infectious Diseases, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Esma Eren
- Department of Infectious Diseases, Kayseri City Hospital, Kayseri, Turkey
| | - Razi Even Dar
- Department of Infectious Diseases, Caemal, Haifa, Israel
| | - Foday Usman Munu
- Department of Infectious Diseases, Lakka Government Hospital, Freetown, Sierra Leone
| | - Esra Guzel Tanoglu
- Department of Molecular Biology and Genetics, University of Health Sciences, Istanbul, Turkey
| | - Esteban Echeverry
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Juan Diego Velez
- Infectious Disease Service Hospital Universitario Fundacion Valle del Lili Colombia, Facultad de Medicina Universidad Icesi, Cali, Colombia
| | - Cumhur Artuk
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Safak Ozer Balin
- Department of Infectious Diseases, Fırat University Medical Faculty, Elazig, Turkey
| | - Nirav Pandya
- Department of Infectious Diseases, Bhailal Amin General Hospital, Vadodara, India
| | - Aysegul Erdem
- Department of Pathology, Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | | | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Training and Research Hospital, Ankara, Turkey
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Imrani K, El Youssfi Z, Acharki M, Belkouchi A, Billah NM, Nassar I. Intraperitoneal tuberculosis abscess: A rare form of tuberculosis. Radiol Case Rep 2023; 18:2314-2316. [PMID: 37138657 PMCID: PMC10149317 DOI: 10.1016/j.radcr.2023.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 05/05/2023] Open
Abstract
Tuberculosis is related to high rate of morbidity and mortality worldwide. Extra-pulmonary forms are increasing in incidence. The diagnosis of extrapulmonary locations, especially abdominal, is often difficult because the clinical and biological signs are not specific, leading to a delay in diagnosis and treatment. The intraperitoneal tuberculosis abscess is a particular radio-clinical entity, due to its atypical and confusing symptomatology. We report the case of a 36-year-old female patient who had a peritoneal tuberculosis abscess manifested by diffuse abdominal pain in a febrile context.
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Affiliation(s)
- Kaoutar Imrani
- Radiology Department, Ibn Sina University Hospital, Mohammed V University, Rabat
- Corresponding author.
| | - Zakia El Youssfi
- Radiology Department, Ibn Sina University Hospital, Mohammed V University, Rabat
| | - Mohamed Acharki
- Digestive Endoscopy Department, Ibn Sina University Hospital, Mohammed V University, Rabat
| | - Abdelkader Belkouchi
- General Surgery Department (A), Ibn Sina University Hospital, Mohammed V University, Rabat
| | | | - Ittimade Nassar
- Radiology Department, Ibn Sina University Hospital, Mohammed V University, Rabat
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29
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Gaillard M, Meylaerts L, Govaerts K. Extrapelvic Endometriosis Mimicking Peritoneal Surface Malignancy: Case Report and a Review of Literature. Indian J Surg Oncol 2023; 14:131-143. [PMID: 37359914 PMCID: PMC10284773 DOI: 10.1007/s13193-022-01683-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/06/2022] [Indexed: 12/04/2022] Open
Abstract
Extrapelvic endometriosis is a rare presentation of endometriosis with atypical clinical symptoms. It can mimic peritoneal surface malignancy, as well as some abdominal infectious diseases. A 29-year-old Moroccan woman presented with abdominal pain, progressive abdominal distention, and an intermittent inflammatory syndrome. Imaging revealed multiple, progressively growing abdominal cysts. She had elevated tumor markers CA125 and CA19.9. Despite thorough investigation, several differential diagnoses persisted for a long time. Definitive pathological diagnosis could only be established after debulking surgery. Literature review on malignant and benign conditions causing multicystic abdominal distention is provided. When definitive diagnosis is not established, but suspicion for peritoneal malignancy remains, a debulking procedure can be undertaken. Organ preservation can be pursued whenever benign disease is still considered. In case of malignancy, short-term (curative) debulking procedure with or without hyperthermic intraperitoneal chemotherapy (HIPEC) can be proposed.
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Affiliation(s)
- Marie Gaillard
- Department of Surgical Oncology, Ziekenhuis Oost Limburg, Genk, Belgium
| | | | - Kim Govaerts
- Department of Radiology, Ziekenhuis Oost Limburg, Genk, Belgium
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30
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Echeverri-Fernandez E, Amezquita MA, Moncada PA, Escobar J, Fernandez-Trujillo L. Peritoneal tuberculosis in an immunocompetent patient: A case report. IDCases 2023; 32:e01785. [PMID: 37234728 PMCID: PMC10205527 DOI: 10.1016/j.idcr.2023.e01785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction Tuberculosis is endemic in Colombia, the prevalence of its pulmonary form in immunocompetent hosts is high, and peritoneal compromise instead is rare and difficult to diagnose. Case presentation A 24-year-old female patient living in a rural area presented to the emergency department with constitutional and gastrointestinal symptoms, including bloating, diarrhea, significant weight loss, nocturnal diaphoresis, and gradual onset of ascites with abdominal pain. Diagnostic workup, including paracentesis, a transvaginal ultrasound, and an abdominal CT scan, did not suggest malignancy or portal hypertension. However, diagnostic laparoscopy revealed a miliary pattern comprising the parietal and pelvic peritoneum, uterus, fallopian tubes, and major omentum suggestive of peritoneal tuberculosis. Anti-tuberculosis therapy was initiated with subsequent microbiological confirmation. Conclusion Abdominal compromise by tuberculosis is a diagnostic challenge, especially in patients with no apparent risk factors. The clinical manifestations and paraclinical data may be unspecific or inconclusive, requiring peritoneal biopsy and empirical treatment before definitive confirmation.
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Affiliation(s)
| | | | - Pablo Andrés Moncada
- Faculty of Health Sciences, Universidad Icesi, Cali, Colombia
- Department of Internal Medicine, Infectious Disease Service, Fundacion Valle del Lili, Cali, Colombia
| | - Juliana Escobar
- Faculty of Health Sciences, Universidad Icesi, Cali, Colombia
- Department of Pathology and Laboratory Medicine, Fundación Valle del Lili, Cali, Colombia
| | - Liliana Fernandez-Trujillo
- Faculty of Health Sciences, Universidad Icesi, Cali, Colombia
- Department of Internal Medicine, Pulmonology Service, Fundación Valle del Lili, Cali, Colombia
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31
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Ebrahimzadeh A, Pagheh AS, Mousavi T, Fathi M, Moghaddam SGM. Serosal membrane tuberculosis in Iran: A comprehensive review of evidences. J Clin Tuberc Other Mycobact Dis 2023; 31:100354. [PMID: 36874623 PMCID: PMC9982686 DOI: 10.1016/j.jctube.2023.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Tuberculosis (TB) is among the most common cause of serositis. There are many uncertainties in diagnostic and therapeutic approach to serous membranes tuberculosis. Our aim in the present review is to discuss the regional facilities for timely diagnosis, rapid decision-making and appropriate treatment regarding to serous membranes tuberculosis; with emphasis on situation in Iran. A comprehensive literature searches about the status of serous membranes tuberculosis in Iran were performed in English databases including Google Scholar, Science Direct, Scopus, Pub Med, and Web of Sciences, Persian SID databases, between 2000 and 2021. The main findings of the present review are as follow: a) pleural tuberculosis is more common than pericardial or peritoneal tuberculosis. b) Clinical manifestations are non-specific and so non-diagnostic. c) Smear and culture, PCR and characteristic granulomatous reaction have been used for definitive TB diagnosis by physicians. d) With Adenosine Deaminase Assays and Interferon-Gamma Release Assays in mononuclear dominant fluid, a possible diagnosis of TB is proposed by experienced physicians in Iran. e) In area of endemic for tuberculosis including Iran, a possible diagnosis of TB is enough to begin empirical treatment. f) In patients with uncomplicated tuberculosis serositis, treatment is similar to pulmonary tuberculosis. First line drugs are prescribed unless evidence of MDR-TB is detected. g) The prevalence of drug resistant tuberculosis (MDR-TB) in Iran is between 1% and 6%, and are treated by empirical standardized treatment. h) It is not known whether adjuvant corticosteroids are effective in preventing long term complication. i) Surgery may be recommended for MDR-TB. Tamponade or constrictive pericarditis and intestinal obstruction. In conclusion, it is recommended to consider serosal tuberculosis in patients who have unknown mononuclear dominant effusion and prolonged constitutional symptoms. Experimental treatment with first line anti-TB drugs can be started based on possible diagnostic findings.
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Affiliation(s)
- Azadeh Ebrahimzadeh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Tahoora Mousavi
- Molecular and Cell Biology Research Center (MCBRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Fathi
- Parasitology Department of Medical School, Tarbiat Modares University, Tehran, Iran
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32
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Cheng BW, Xie PW, Miao YS, Li GH. Feasibility and Safety of Transgastric Natural Orifice Transluminal Endoscopic Surgery in the Diagnosis of Ascites of Unknown Origin. J Laparoendosc Adv Surg Tech A 2023; 33:200-204. [PMID: 36201261 DOI: 10.1089/lap.2022.0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The purpose of this study was to evaluate the feasibility and safety of transgastric natural orifice transluminal endoscopic surgery (TG-NOTES) combined with biopsy in the diagnosis of unknown ascites. Method: This retrospective study used data from the first affiliated hospital of Nanchang university on 51 patients who were diagnosed with ascites of unknown origin between January 2013 and May 2019 and experienced peritoneal biopsy through TG-NOTES. The outcome measures included diagnostic accuracy and procedure-related adverse events. Results: TG-NOTES was performed successfully in 46 of 51 patients, tuberculous ascites in 38 cases, carcinomatous ascites in 4 cases, cirrhotic ascites in 1 case, and 3 cases showed no obvious abnormalities in pathological result. Five cases failed to be diagnosed because of abdominal adhesions. The diagnostic rate of TG-NOTES was 84.3%. There were no severe procedure-related adverse events and no mortality. All patients had good wound healing and no complaint of discomfort on follow-up. Conclusion: The majority of ascites of unknown origin can be expounded through TG-NOTES combined with biopsy without severe complication, therefore, it is a feasible and safe method to detect the cause of unexplained ascites.
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Affiliation(s)
- Bo-Wen Cheng
- Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Pei-Wei Xie
- Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Yin-Shui Miao
- Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Guo-Hua Li
- Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
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33
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Tay TY, Nordin N, Badaruddin IA, Othman H. A Patient with Third-Space Fluid Loss. Clin Chem 2023; 69:125-128. [PMID: 36724481 DOI: 10.1093/clinchem/hvac205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/30/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Tien Yaa Tay
- Chemical Pathology Unit, Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nabihah Nordin
- Chemical Pathology Unit, Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Izzatul Aliaa Badaruddin
- Chemical Pathology Unit, Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hanita Othman
- Chemical Pathology Unit, Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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34
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Tahaineh S, Mughli RA, Seetan K, Alriyalat S, Agahi D. Tuberculous peritonitis post orchiectomy for testicular tuberculosis; a case report and literature review. Radiol Case Rep 2023; 18:1084-1087. [PMID: 36684640 PMCID: PMC9849869 DOI: 10.1016/j.radcr.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023] Open
Abstract
Tuberculous peritonitis, though rare, is a serious condition and its diagnosis is challenging due to nonspecific clinical symptoms and imaging findings. Likewise, tuberculous epididymo-orchitis is a clinical dilemma, as it often mimics testicular tumors. We report a case of a 62-year-old patient diagnosed to have TB peritonitis, following tuberculous epididymo-orchitis with review of the imaging features of both entities. A high index of suspicion and careful clinical assessment will help in early diagnosis and treatment of TB peritonitis, preventing potential complications. Moreover, testicular tuberculosis should be considered in the differential diagnosis of scrotal mass.
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Affiliation(s)
| | - Rawan Abu Mughli
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Khaled Seetan
- Yarmouk University Faculty of Medicine, Irbid, Jordan
| | | | - Daniel Agahi
- University of Western Ontario, London, 106 Wood Rim dr, L4E 4M9, Richmond Hill, ON, Canada,Corresponding author.
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35
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Muacevic A, Adler JR, Yokosawa T. Sclerosing Encapsulating Peritonitis: Abdominal Cocoon. Cureus 2023; 15:e34322. [PMID: 36721711 PMCID: PMC9884389 DOI: 10.7759/cureus.34322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 01/30/2023] Open
Abstract
Sclerosing encapsulating peritonitis is a rare chronic inflammatory condition often with unknown origins. We report a case of an abdominal cocoon or sclerosing encapsulating peritonitis, which was suspected to be a result of bowel obstruction. Tuberculosis peritonitis was also suspected. However, the exact diagnosis was unclear, and it was diagnosed as an idiopathic abdominal cocoon. The patient's history is of clear relevance in this diagnosis, and this report will be of interest to clinicians attending to cases of bowel obstruction.
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36
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Wynne J, Chew K, Kothari P, Bressman M, Tow C. A Peculiar Peritoneum: A Case of Tuberculosis in a Male Without Known Risk Factors. J Investig Med High Impact Case Rep 2022; 10:23247096221142278. [PMID: 36476082 PMCID: PMC9742681 DOI: 10.1177/23247096221142278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Peritoneal tuberculosis is an uncommon diagnosis in developed countries and most commonly presents in patients with known risk factors for tuberculosis. We report a case of a patient without tuberculosis risk factors who presented with 4 years of intermittent fevers, several weeks of increasing abdominal distention, and newly discovered elevated liver tests. The diagnosis of peritoneal tuberculosis was confirmed following an extensive workup with a positive ascitic fluid culture for Mycobacterium tuberculosis. The patient's fevers resolved with antibiotic therapy, and antibiotic therapy was subsequently de-escalated based on the susceptibility profile.
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Affiliation(s)
- Joshua Wynne
- Montefiore Medical Center Department of Internal Medicine, Bronx, NY, USA,Joshua Wynne, MD, Department of Medicine, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
| | - Kimberline Chew
- Montefiore Medical Center Department of Internal Medicine, Bronx, NY, USA
| | - Pooja Kothari
- Montefiore Medical Center Department of Internal Medicine, Bronx, NY, USA
| | - Maxwell Bressman
- Montefiore Medical Center Department of Internal Medicine, Bronx, NY, USA,Albert Einstein College of Medicine, Bronx, NY, USA
| | - Clara Tow
- Albert Einstein College of Medicine, Bronx, NY, USA,Montefiore Medical Center Division of Hepatology, Bronx, NY, USA
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Muacevic A, Adler JR, Jacob VA, Sainath S. Abdominal Tuberculosis Presenting as an Umbilical Sinus: A Case Report. Cureus 2022; 14:e31184. [PMID: 36505153 PMCID: PMC9727654 DOI: 10.7759/cureus.31184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 11/09/2022] Open
Abstract
Abdominal tuberculosis, a form of extrapulmonary tuberculosis is common in developing countries like India. Manifestations of abdominal tuberculosis are widely variable. Its incidence is high among human immunodeficiency virus (HIV) infected patients in the adult population. Here, we report a 26-year-old male, initially treated in a private clinic for abdominal distention, loss of appetite, and loss of weight for one month. Magnetic resonance imaging (MRI) of the abdomen showed a large loculated fluid collection. Computed tomography (CT) of the chest showed signs of pulmonary tuberculosis. The patient was started on anti-tuberculosis therapy (ATT) and discharged. Ten days later, the patient presented to our hospital with foul-smelling pus discharging from the umbilicus and necrosis of the surrounding tissue. Abdominal examination revealed a tense, distended, and tender abdomen. The patient was referred for emergency laparotomy. The intraoperative findings showed features that were a combination of plastic fibrous type and encysted loculated type of peritoneal tuberculosis. The above-mentioned case describes a very uncommon presentation of abdominal tuberculosis. A high degree of suspicion is required for diagnosing such conditions, especially in immunocompromised individuals. The case report also highlights the difficulties in the diagnosis of abdominal tuberculosis.
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Iftikhar A, Nisar M, Sheikh HS, Sultan F. The Case of the Young Male with a Longstanding History of Dyspeptic Symptoms: Peritoneal Tuberculosis. Cureus 2022; 14:e29612. [PMID: 36321009 PMCID: PMC9601928 DOI: 10.7759/cureus.29612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/26/2022] Open
Abstract
Portal vein thrombosis associated with peritoneal tuberculosis is an uncommon manifestation of extrapulmonary tuberculosis. We report one such case of a 33-year-old male with a one-year history of dyspepsia, having been on proton pump inhibitors all this time with temporary relief. In view of ongoing symptoms, an endoscopy was done, which at first showed duodenal ulcer. On repeat endoscopy after an interval, there was evidence of mucosa-associated lymphoid tissue (MALT) lymphoma, which prompted a host of investigations in the patient. A positron emission tomography (PET) scan revealed extensive omento-peritoneal involvement along with a hypodense lesion in the liver with interval development of portal vein thrombosis on a CT scan of the abdomen. The biopsy of the hepatic lesion showed granulomatous inflammation. Faced with a diagnostic dilemma, finally, a laparoscopic biopsy was done, which confirmed the diagnosis of peritoneal TB with portal vein thrombosis. This case highlights the importance of keeping a high index of suspicion to include tuberculosis as a differential when presented with a case such as this and to conduct appropriate investigations to establish the correct diagnosis.
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Du L, Wei X, Xiao Z, Wang H, Song Y. Utility of ascitic tumor markers and adenosine deaminase for differential diagnosis of tuberculous peritonitis and peritoneal carcinomatosis. BMC Gastroenterol 2022; 22:423. [PMID: 36115972 PMCID: PMC9482723 DOI: 10.1186/s12876-022-02480-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Differential diagnosis between tuberculous peritonitis and peritoneal carcinomatosis remains challenging in clinical practice; thus, in-patients diagnosed with tuberculous peritonitis or peritoneal carcinomatosis were retrospectively enrolled, and diagnostic values of ascitic tumor markers and adenosine deaminase were determined. METHODS Consecutive patients diagnosed with tuberculous peritonitis or peritoneal carcinomatosis were retrospectively enrolled. The pertinent data of 169 patients enrolled were collected. RESULTS A panel of ascitic tumor makers (CEA, CA15-3, CA19-9) had high specificity (96.83%) and accuracy (94.67%) in the differentiation of peritoneal carcinomatosis from tuberculous peritonitis; and ascitic ADA was a good discriminator between these patients, with an accuracy of 91.72%. Combined use of ascitic tumor makers and ADA (ascitic ADA < 22.5 IU/L or ascitic CEA > 3.65 ng/mL or CA15-3 > 42.70 U/mL or CA19-9 > 25.10 U/mL) performed high sensitivity (99.06%) and accuracy (94.08%) for the diagnosis of peritoneal carcinomatosis. In addition, combined ascitic ADA and tumor marker (positive ascitic tumor makers and ADA < 22.50 IU/L) had 100% of the specificity in diagnosing peritoneal carcinomatosis. CONCLUSIONS Combined use of ascitic tumor markers and adenosine deaminase showed excellent efficiency in the differential diagnosis between tuberculous peritonitis and peritoneal carcinomatosis, thus these two simple and cost-effective parameters should be determined when tuberculous peritonitis or peritoneal carcinomatosis was suspected in clinic practice.
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Affiliation(s)
- Li Du
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiuqi Wei
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zhuanglong Xiao
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hui Wang
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Yuhu Song
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Misra R, Kar M, Mohindra S, Gupta A. Acid fast bacillus smear, mycobacterial culture and Xpert MTB/RIF assay for the diagnosis of tuberculous peritonitis in patients with and without end stage renal failure. Access Microbiol 2022; 4:acmi000414. [PMID: 36133176 PMCID: PMC9484662 DOI: 10.1099/acmi.0.000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Diagnosis of tuberculous peritonitis (TBP) requires a high index of suspicion. Hypothesis /gap statement. Information about the diagnostic features of TBP among patients with end-stage renal failure (ESRF) from India is limited. Aim. To assess the utility of the Gene Xpert MTB/RIF assay in the diagnosis of TBP in patients with end-stage renal failure (ESRF), compared with those without ESRF. Methodology. This prospective observational single centre cohort study was performed at a tertiary care centre in Northern India. Ascitic fluid and/or whole continuous ambulatory peritoneal dialysis (CAPD) bag with effluent from 300 clinically suspected cases of TBP were included in the study. Diagnosis was based on detection of Mycobacteria on smear, Xpert MTB/RIF assay and/or culture. Cell counting was done in a Neubauer chamber. Cell predominance was seen by Giemsa stain. Line probe assay (LPA) for drug susceptibility testing was performed on all positive cultures. Results. TBP was diagnosed in 168 cases. Diabetes mellitus was a significant risk factor for developing TBP in patients with ESRF (P value<0.01). Lymphocytic predominance was seen in 21 patients without ESRF (P value 0.033) while majority of the patients in both groups had neutrophils in their ascitic and peritoneal fluids (138/168; P value 0.033). We recovered 15 cases of laboratory diagnosed TBP (11 without ESRF and four with ESRF). Microscopy was positive in two cases while ten isolates were recovered on culture. The Xpert MTB/RIF assay was positive in seven ascitic fluid samples out of which three were rifampicin resistant. All these were patients without renal failure (P value 0.010). Eight culture positive samples tested by the line probe assay did not detect any resistance to either rifampicin or isoniazid. Conclusion. The GeneXpert MTB/RIF assay has a limited value in the diagnosis of TBP in patients with ESRF.
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Affiliation(s)
- Richa Misra
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India
| | - Mitra Kar
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India
| | - Samir Mohindra
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India
| | - Amit Gupta
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014, India
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Allaeys C, De Backer P, Decaestecker K, Berquin C, Decaestecker K, Callens S, Van Praet C. Peritoneal tuberculosis caused by intravesical instillation with Bacillus Calmette-Guérin (BCG) following nephroureterectomy in a patient with bladder and upper tract urothelial cancer: a case report. Acta Clin Belg 2022; 78:257-260. [PMID: 35943041 DOI: 10.1080/17843286.2022.2110688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The standard treatment for high-risk non-muscle-invasive bladder cancer (NMIBC) is trans-urethral resection of the bladder (TURB) followed by instillation of Bacillus Calmette-Guérin (BCG). The occurrence of peritoneal tuberculosis after intravesical BCG instillation is extremely rare and difficult to diagnose. METHODS We report the case of a 79-year-old man with urothelial cell carcinoma (UCC) of the kidney and bladder who developed peritoneal tuberculosis after consecutive TURB and nephroureterectomy followed by intravesical BCG instillation. Further investigation revealed an undiagnosed bladder leak. CONCLUSION This case serves as a reminder for urologists to be suspicious for urothelium discontinuity when administering BCG shortly after bladder surgery.
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Affiliation(s)
| | - Pieter De Backer
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | | | - Camille Berquin
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Karen Decaestecker
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Steven Callens
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
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Di Buono G, Vella R, Amato G, Romano G, Rodolico V, Saverino M, De Lisi G, Romano G, Buscemi S, Agrusa A. Totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation: The first case report in worldwide literature with a brief review. Front Surg 2022; 9:956124. [PMID: 36017513 PMCID: PMC9395922 DOI: 10.3389/fsurg.2022.956124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Bowel perforation is a relatively rare presentation of abdominal tuberculosis, whose diagnosis is challenging but fundamental to minimize morbidity and mortality. Laparoscopy is considered an effective modality for diagnosis, but its role in surgical treatment is still not established. We reported the first worldwide case of totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation. CASE PRESENTATION A 30-year-old man with a history of weight loss, preceded by 2 years of nonproductive cough, was admitted to the Infectious Disease Department with a presumed diagnosis of tuberculosis. A microbiological culture test confirmed the diagnosis, and the patient undertook quadruple antituberculous therapy. During hospitalization, he presented sudden abdominal pain, fever, and vomit. An abdominal CT scan showed small bowel perforation with granulomatous reaction. Laparoscopy was performed and revealed a 2 cm perforation on the medium ileum. Small bowel resection and totally intracorporeal side-to-side anastomosis were performed. No complication occurred until a clinical follow-up of 2 months. CONCLUSION In consideration of the increasing incidence of intestinal TB in both underdeveloped and Western countries, the diagnosis of this pathology should be taken into account in high-risk patients. Probably, the diagnostic challenges and emergency settings of intestinal TB with perforation and peritonitis, together with the lack of standardized guidelines regarding surgical management, make the use of laparoscopy apparently arduous, but the known advantages of laparoscopy and its technical feasibility should make it a conceivable option for the treatment of complicated cases.
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Affiliation(s)
- Giuseppe Di Buono
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Roberta Vella
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppe Amato
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giorgio Romano
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Vito Rodolico
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities (PROMISE), University of Palermo, Palermo, Italy
| | - Marta Saverino
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giovanni De Lisi
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities (PROMISE), University of Palermo, Palermo, Italy
| | - Giorgio Romano
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Buscemi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Antonino Agrusa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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Ning Q, Chen T, Wang G, Xu D, Yu Y, Mao Q, Li T, Li L, Li J, Lu X, Li J, Li Z, Zhang W, Xiao Y, Meng Q, Mi Y, Shang J, Yu Y, Zhao Y, Zhao C, Zhao H, Huang J, Peng J, Tang H, Tang X, Hu J, Hu B, Guo W, Zheng B, Chen B, Zhang Y, Wei J, Sheng J, Chen Z, Wang M, Xie Q, Wang Y, Wang FS, Hou J, Duan Z, Wei L, Jia J, Chinese Society of Infectious Disease of Chinese Medical Association. Expert Consensus on Diagnosis and Treatment of End-Stage Liver Disease Complicated with Infections. INFECTIOUS DISEASES & IMMUNITY 2022; 2:168-178. [DOI: 10.1097/id9.0000000000000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Indexed: 10/13/2023]
Abstract
Abstract
End-stage liver disease (ESLD) is a life-threatening clinical syndrome that markedly increases mortality in patients with infections. In patients with ESLD, infections can induce or aggravate the occurrence of liver decompensation. Consequently, infections are among the most common complications of disease progression. There is a lack of working procedure for early diagnosis and appropriate management for patients with ESLD complicated by infections as well as local and international guidelines or consensus. This consensus assembled up-to-date knowledge and experience across Chinese colleagues, providing data on principles as well as working procedures for the diagnosis and treatment of patients with ESLD complicated by infections.
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Affiliation(s)
- Qin Ning
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tao Chen
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Guiqiang Wang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China
| | - Dong Xu
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yanyan Yu
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China
| | - Qing Mao
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Chongqing 400038, China
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Lanjuan Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jun Li
- Department of Infectious Disease, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Xiaoju Lu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Jiabin Li
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei 230031, China
| | - Zhiwei Li
- Department of Infectious Diseases, Shengjing Hospital, Affiliated Hospital of China Medical University, Shenyang 110801, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Institute of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Qinghua Meng
- Department of Severe Liver Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Yuqiang Mi
- Nankai University Second People's Hospital, Tianjin 300071, China
| | - Jia Shang
- Department of Infectious Disease, People's Hospital of Henan Province, Zhengzhou 450003, China
| | - Yunsong Yu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310020, China
| | - Yingren Zhao
- Department of Infectious Diseases, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
| | - Caiyan Zhao
- Department of Infectious Diseases, Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - Hong Zhao
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China
| | - Jianrong Huang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jie Peng
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hong Tang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoping Tang
- Research Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Jinhua Hu
- Liver Failure Treatment and Research Center, The Fifth Medical Center, China PLA General Hospital, Beijing 100039, China
| | - Bijie Hu
- Department of Infectious Diseases, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Wei Guo
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bo Zheng
- Institute of Clinical Pharmacology, Peking University First Hospital, Beijing 100034, China
| | - Baiyi Chen
- Department of Infectious Diseases, The First Hospital of China Medical University, Shenyang 110002, China
| | - Yuexin Zhang
- Center of Infectious Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Jia Wei
- Department of Infectious Disease, The Second People's Hospital, Kunming 650201, China
| | - Jifang Sheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Zhi Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Minggui Wang
- Department of Infectious Diseases, Institute of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qing Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Yuming Wang
- Department of Infectious Diseases, Southwest Hospital, Army Medical University, Chongqing 400038, China
| | - Fu-Sheng Wang
- Liver Failure Treatment and Research Center, The Fifth Medical Center, China PLA General Hospital, Beijing 100039, China
| | - Jinlin Hou
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Zhongping Duan
- Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Lai Wei
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University Hepatology Institute, Peking University People's Hospital, Beijing 100044, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medial University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
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Lytsikas-Sarlis P, Gkagkaris L, Papadakis M. Letter to the Editor: Peritoneal Tuberculosis Presenting with Atypical Symptoms and Elevated Cancer Antigen 125. Surg Infect (Larchmt) 2022; 23:497-498. [PMID: 35475672 DOI: 10.1089/sur.2022.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Loukas Gkagkaris
- Department of General Surgery, "Konstantopouleio," General Hospital of N. Ionia, N. Ionia, Athens, Greece
| | - Marios Papadakis
- Department of Surgery II, University Witten-Herdecke, Wuppertal, Germany
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Lin LC, Kuan WY, Shiu BH, Wang YT, Chao WR, Wang CC. Primary malignant peritoneal mesothelioma mimicking tuberculous peritonitis: A case report. World J Clin Cases 2022; 10:3156-3163. [PMID: 35647134 PMCID: PMC9082704 DOI: 10.12998/wjcc.v10.i10.3156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/08/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant peritoneal mesothelioma (MPM) is a rare malignancy arising in mesothelial cells in the peritoneum. It can be mistaken for many other diseases, such as peritoneal carcinomatosis and tuberculous peritonitis (TBP), because its clinical manifestations are often nonspecific. Therefore, the diagnosis of MPM is often challenging and delayed.
CASE SUMMARY A 42-year-old man was referred to our hospital with lower abdominal pain for 1 wk and ascites observed under abdominal sonography. His laboratory findings revealed an isolated elevated tumor marker of carcinoma antigen 125 (167.4 U/mL; normal, < 35 U/mL), and contrast enhanced computed tomography showed peritoneal thickening. Thus, differential diagnoses of TBP, carcinomatosis of an unknown nature, and primary peritoneal malignancy were considered. After both esophagogastroduodenoscopy and colonoscopy produced negative findings, laparoscopic intervention was performed. The histopathological results revealed mesothelioma invasion into soft tissue composed of a papillary, tubular, single-cell arrangement of epithelioid cells. In addition, immunohistochemical staining was positive for mesothelioma markers and negative for adenocarcinoma markers. Based on the above findings, TBP was excluded, and the patient was diagnosed with MPM.
CONCLUSION It is important to distinguish MPM from TBP because they have similar symptoms and blood test findings.
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Affiliation(s)
- Li-Cheng Lin
- Department of Education, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Wen-Yen Kuan
- Department of Education, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Bei-Hao Shiu
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Yu-Ting Wang
- Department of Pathology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Wan-Ru Chao
- Department of Pathology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chi-Chih Wang
- Division of Endoscopy, Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
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Hammami F, Ben Ayed H, Koubaa M, Chakroun A, Hsairi M, Smaoui F, Gargouri L, Rekik K, Ben Jemaa M. Clinical, laboratory and evolutionary features of abdominal tuberculosis in comparison with other forms of extrapulmonary tuberculosis. Indian J Tuberc 2022; 69:184-190. [PMID: 35379400 DOI: 10.1016/j.ijtb.2021.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/19/2021] [Accepted: 07/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/OBJECTIVES Tuberculosis is a multisystem disease that might affect any organ. Abdominal tuberculosis (ABT) represents 5-17% from all extrapulmonary tuberculosis (EPT) sites. We aimed to study the clinical, laboratory and evolutionary features of ABT cases and to identify predictive factors associated with ABT. METHODS We conducted a retrospective study including all patients hospitalized in the infectious diseases department for EPT between 1991 and 2019. We studied the characteristics of ABT cases, and we compared them with other EPT cases. RESULTS We identified 519 patients with EPT, among whom 86 (16.6%) patients had ABT. There were 58 females (67.4%). Peritoneal tuberculosis was the most common clinical form of ABT (68.6%), followed by intestinal tuberculosis (18.6%). Patients aged 60 years and above were significantly less affected with ABT (odds ratio (OR) = 0.2; p = 0.001). The revealing systemic symptoms including fever (OR = 2.04; p = 0.006), weight loss (OR = 2.5; p < 0.001) and anorexia (OR = 1.7; p = 0.021) were significantly more frequent among ABT patients. Inflammatory markers including C-reactive protein levels (37 [10-89] mg/l vs 10 [4-57] mg/l; p < 0.001) and erythrocyte sedimentation rates (43 [15-95] mm/h vs 27 [15-60] mm/h; p = 0.044) were significantly higher among ABT cases. Multivariate logistic regression analysis showed that anorexia (adjusted OR (AOR) = 1.9; p = 0.015) and pulmonary involvement (AOR = 3.3; p = 0.002) were independent predictors of higher rate of ABT. Concomitant involvement of neuro-meningeal (AOR = 0.18; p = 0.001) and osteo-articular (AOR = 0.2; p = 0.01) sites, 40-59 (AOR = 0.2; p < 0.001) and ≥60 (AOR = 0.2; p < 0.001) age groups as well as hemoglobin rate (AOR = 0.7; p < 0.001) were independently associated with lower rate of ABT. CONCLUSIONS Anorexia and pulmonary involvement were independent predictors of higher rate of ABT. Concomitant involvement of neuro-meningeal and osteo-articular sites, 40-59 and ≥60 age groups and hemoglobin rate were independently associated with lower rate of ABT.
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Affiliation(s)
- Fatma Hammami
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia.
| | - Houda Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Makram Koubaa
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia.
| | - Amal Chakroun
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Manel Hsairi
- Pediatric Emergency and Reanimation Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Fatma Smaoui
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Lamia Gargouri
- Pediatric Emergency and Reanimation Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Khaoula Rekik
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mounir Ben Jemaa
- Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia
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Kumari P, Dhiman A, Lavania S, Sharma P, Rath D, Anthwal D, Gupta RK, Kochar A, Sharma N, Gadpayle A, Taneja R, Sharma L, Haldar S, Sharma TK, Tyagi JS. Assessment of DNA aptamers targeting GlcB and HspX antigens for application in the diagnosis of abdominal tuberculosis. Tuberculosis (Edinb) 2022; 134:102206. [DOI: 10.1016/j.tube.2022.102206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023]
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Diagnosis of abdominal tuberculosis by mini-laparoscopy. Infection 2022; 50:1049-1050. [PMID: 35304694 PMCID: PMC9338114 DOI: 10.1007/s15010-022-01800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/03/2022] [Indexed: 11/05/2022]
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Minamikawa M, Okazaki A, Yoshida N. Tuberculous pleuroperitonitis. Clin Case Rep 2022; 10:e05530. [PMID: 35261775 PMCID: PMC8888805 DOI: 10.1002/ccr3.5530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/16/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022] Open
Abstract
An 83-year-old man was diagnosed with tuberculous pleuroperitonitis on a thoracoscopic pleural biopsy. It may be due to endogenous reactivation of the foci in the pleura and peritoneum. Thoracoscopy, which can be performed under local anesthesia, should be considered when both pleural effusion and ascites are present.
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Affiliation(s)
- Maki Minamikawa
- Department of Respiratory MedicineKaga Medical CenterKagaJapan
| | - Akihito Okazaki
- Department of Respiratory MedicineKaga Medical CenterKagaJapan
| | - Naruo Yoshida
- Department of Respiratory MedicineKaga Medical CenterKagaJapan
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Thomson BKA, Vaughan S, Momciu B. Mycobacterium tuberculosis peritonitis in peritoneal dialysis patients: A scoping review. Nephrology (Carlton) 2022; 27:133-144. [PMID: 34743395 DOI: 10.1111/nep.13997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The clinical syndrome of Mycobacterium tuberculosis (M. tuberculosis) peritoneal dialysis (PD) peritonitis is poorly understood. Whether local tuberculosis (TB) patterns modify the clinical syndrome, and what factors associate with poor outcomes is also unknown. METHODS A scoping review identified published cases of TB PD peritonitis. Cases from low- and high-TB burden areas were compared, and cases that did or did not suffer a poor clinical outcome were compared. RESULTS There were 216 cases identified. Demographics, presentation, diagnosis, treatment and outcomes were described. Significant delays in diagnosis were common (6.1 weeks) and were longer in patients from low-TB burden regions (7.3 vs. 3.7 weeks). In low-TB burden areas, slower diagnostic methods were more commonly used like PD fluid culture (64.3% vs. 32.7%), and treatment was less likely with quinolone antibiotics (6.9% vs. 34.1%). Higher national TB incidence and lower GDP per capita were found in cases that suffered PD catheter removal or death. Diagnostic delays were not longer in cases in which a patient suffered PD catheter removal or death. Cases that suffered death were older (51.9 vs. 45.1 years) and less likely female (37.8% vs. 55.7%). Removal of PD catheter was more common in cases in which a patient died (62.0% vs. 49.1%). CONCLUSIONS Outcomes in TB PD peritonitis are best predicted by national TB incidence, patient age and sex. Several unique features are identified to alert clinicians to use more rapid diagnostic methods that might enhance outcomes in TB PD peritonitis.
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Affiliation(s)
- Benjamin K A Thomson
- Department of Medicine, Division of Nephrology, Queen's University, Kingston, Ontario, Canada
- School of Public Health, Johns Hopkins Bloomberg, Baltimore, Maryland, USA
| | - Stephen Vaughan
- Department of Medicine, Division of Infectious Diseases, University of Calgary. Foothills Medical Centre (North Tower), Calgary, Alberta, Canada
| | - Bogdan Momciu
- Department of Medicine, Division of Nephrology, Queen's University, Kingston, Ontario, Canada
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