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00003. Tuberculous peritonitis: fatality associated with delayed diagnosis.

1. South Med J. 1999 Apr;92(4):406-8.

Ahmad M, Ahmed A.
Department of Medicine, Baqai Hospital, Baqai Medical College, Karachi, Pakistan.

We describe a fatal case of tuberculous peritonitis and review the literature on  the diagnostic modalities available to diagnose this entity. We suspect a delayed
diagnosis resulted in the death of our patient. Today, the prompt diagnosis of an unknown ascitic process involves laparoscopy. A patient with unknown large volume
ascites is the easiest and safest to laparoscope. Using a mini laparoscope, a bedside procedure with instantaneous return can be done. The newer noninvasive
tests like determination of ascites fluid adenosine deaminase activity and polymerase chain reaction may be helpful in the prompt diagnosis of peritoneal
tuberculosis. We recommend that patients with clinical presentation suggestive of peritoneal tuberculosis have either an aggressive diagnostic workup using
high-yield tests or a trial of antituberculous therapy.

PMID: 10219360 [PubMed - indexed for MEDLINE]