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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tuberculous peritonitis is an uncommon disorder and is often not considered on initial evaluation of ascites. A negative 5-TU PPD test, a normal chest roentgenogram, or a low level of ascitic fluid protein may erroneously direct attention away from tuberculosis. Failure to thoroughly evaluate nonmalignant exudative ascites, especially in alcoholics, is a common diagnostic pitfall. TB peritonitis should be considered in the differential diagnosis in every patient who presents with ascites, fever, and abdominal pain, particularly when alcoholism, a lung lesion, weight loss, or cirrhosis is also present. Percutaneous needle biopsy of peritoneum, followed by peritoneoscopy if necessary, may preclude the need for laparotomy. Antituberculous drugs, when conscientiously taken, afford a rapid response with a cure in most patients. Case material on four patients is presented.
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PMID:Tuberculous peritonitis. 51 68

Five Vietnamese patients with tuberculous peritonitis are described. Fever, x-ray evidence of pulmonary tuberculosis, or positive PPD skin tests were absent in several patients. The diagnosis was considered only when routine paracentesis demonstrated ascitic fluids with increased protein concentrations and lymphocytic pleocytosis. Ascitic fluid glucose concentrations were less than 30 mg./100 cc. in three of five patients.
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PMID:Tuberculous peritonitis. Low ascitic fluid glucose concentration as a diagnostic aid. 99 92

Although conventional wisdom advises removal of the Tenckhoff catheter as part of the therapy for tuberculous peritonitis, there are a few recent reports of cases successfully treated while maintaining the patients on CAPD. We wish to report three cases treated without interrupting CAPD. In two of the patients, cultures were positive for Mycobacterium tuberculosis and in the third case, although the cultures were negative, the patient improved on anti-Tb medications. Smear for AFB was positive in one patient; and two had a positive PPD. All had predominance of lymphocytes and monocytes in effluent. The total WBC count was 160-300 and two patients had fever. All had abdominal pain. One patient was treated with INH and ethambutol; one with INH and rifampin and one (who was suspected of being HIV+) also received pyrazinamide (PZA) until culture was available. Cultures grew in 4-6 weeks. All were started on therapy prior to having the culture results, and all showed clinical improvement within two weeks. One patient had his catheter replaced two months later because of pseudomonas peritonitis, continued on CAPD for an additional five months, then changed to HD because of recurrent bacterial peritonitis. One patient died of complications of diabetic vascular disease three months later with no evidence of peritonitis. One patient has remained on anti-Tb treatment for seven months and is doing well on CAPD.
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PMID:Successful treatment of tuberculous peritonitis while maintaining patient on CAPD. 168 Apr 1

From 1972 to 1989, 20 cases of tuberculous peritonitis were seen in Tokyo Metropolitan Geriatric Hospital. In 13 patients the diagnosis of tuberculous peritonitis was made only at autopsy, which in 7 patients was made during life. Of all 20 cases the mean age was 78 years, with a range of 63 to 96 years. There were no differences in mean ages between autopsied patients and clinically diagnosed patients. There were 11 male and 9 female patients. In autopsied patients 6 were male and 7 were female. Of the clinically diagnosed patients 5 were male and 2 were female. Seven of 13 patients who were diagnosed at autopsy had liver diseases, for example liver fibrosis, liver cirrhosis, hepatocellular carcinoma or chronic hepatitis. In 4 of 7 patients who were diagnosed during life, ileus was also present and their diagnosis of tuberculous peritonitis was made at operation. Only 6 patients had tuberculin test with intermediate strength PPD. There were no positive reactions. In patients who were diagnosed during life, abdominal swelling, anorexia, abdominal pain and fever, the most common clinical manifestations, were seen in 100%, 75%, 50% and 86%, respectively. In contrast, they were seen in 33%, 57%, 0% and 62%, respectively, in autopsied patients. The volume of ascitic fluid varied from zero to 3000 cc. Total white-cell count in the peripheral blood was within or lower than the normal range in 85% of all 20 cases. The lymphocytes count in the peripheral blood was decreased in 95% of all 20 cases. There were no characteristic features in the serum biochemical analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and pathological features of tuberculous peritonitis in the elderly]. 207 56

We report 14 patients with tuberculous peritonitis presenting as persistent and exudative ascites. We found a primary site of tuberculous infection in only 10% of the patients. PPD test was positive in 9 patients. Ascitic fluid showed a protein content in excess of 3.5 g/dl. and more than 300 cells/mm3, mainly lymphocytes, in all patients, Ziehl stain and the culture for Tb. bacilli were negative in all cases. The confirmatory diagnosis was made by laparoscopy and peritoneal biopsy. Good views were obtained on all occasions, and there was no morbidity. Appearances were similar in all cases. Multiple white tubercles were scattered over the parietal and visceral peritoneum. filmy adhesions were present. Four patients had cirrhotic liver disease confirmed by laparoscopy. The biopsy specimen showed caseating granulomata, and the auramine stain was positive in four cases. We conclude that laparoscopy and biopsy is a safe and effective method of obtaining an early diagnosis in patients with tuberculous ascites, especially if they also have cirrhosis.
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PMID:Laparoscopic diagnosis of tuberculous ascites. 621 90

We clinico-statistically studied 8 patients (0.77%) with tuberculous peritonitis (3 cases) and tuberculous endometritis (5 cases) aged 50 or older who visited our gynecological clinic for 6 years from July, 1986 to June, 1992 in Tokyo Metropolitan Tama Geriatric Hospital. The mean age was 72 years with a range of 52 to 82 years. Five cases with tuberculous endometritis were diagnosed based on the findings of endometrial cytology and bacteriology, and the incidence was 0.93% of 535 cases in which the uterine cavity could be examined. Three cases with tuberculous peritonitis were strongly suspected by the ascitic findings (cytology and adenosine deaminase level), and culture of ascitic fluid for acid-fast bacilli was positive in 2 of the three cases. Another case with negative culture was diagnosed based on the marked improvement of clinical findings and symptoms during chemotherapy for tuberculosis. No cases were complicated by active lung tuberculosis. All cases had a family and/or past history of pulmonary tuberculosis. The PPD skin test was positive in 7 of the 8 cases. In all cases, the clinical laboratory data and symptoms were markedly improved by chemotherapy for tuberculosis. Endometrial cytology and transvaginal ultrasonography were very effective methods for the diagnosis of tuberculous endometritis and peritonitis associated with ascites.
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PMID:[Clinico-statistical study on tuberculous peritonitis and genital tuberculosis in elderly women]. 773 40

Four boys with abdominal tuberculosis, one of whom had acquired immunodeficiency syndrome, are presented. Abdominal imaging findings on plain radiography, ultrasonography, computed tomography, and gastrointestinal contrast studies included tuberculous peritonitis and ascites in all patients, tuberculous adenopathy in two, gastrointestinal tuberculosis in two, and omental tuberculosis in two. The radiographic features particularly characteristic of abdominal tuberculosis were: (1) low attenuating adenopathy with rim enhancement, (2) omental or ileocecal inflammatory mass, (3) high density ascites, and (4) gastrointestinal enteritis involving the ileocecal region. All patients had acid-fast bacilli identified in cultures of bodily fluids and/or pathologic specimens and three patients had cultures positive for Mycobacterium tuberculosis. The patient with a negative culture had a positive PPD skin test and a surgical specimen showing caseating granulomata and acid-fast bacilli in the omentum. The radiologist must maintain a high degree of suspicion for abdominal tuberculosis particularly in normal or immunosuppressed children with acquired immunodeficiency syndrome. Fine needle aspiration and biopsy of abdominal adenopathy, inflammatory mass or ascites may be necessary for diagnosis.
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PMID:Abdominal tuberculosis in children. 788 76