1887

Abstract

Introduction:

Indigenous people tend to have higher incidence of infection (TB). The diagnosis of TB is a challenge among older patients because of its non-specific presentation, especially for cases of extrapulmonary TB.

Case presentation:

A 77-year-old indigenous woman presented with ascites secondary to abdominal TB. A computed tomography scan of the abdomen showed free fluid. The patient had a positive tuberculin test, and the ascitic fluid was an exudate with an adenosine deaminase activity test value of 80.76 IU l.The mesenteric lymph biopsy showed a central area with caseating granulomas and peripheral giant cells, suggestive of TB commitment at the mesenteric lymph node level. The diagnosis was confirmed by a positive TB ascitic fluid culture. Anti-TB treatment improved the patient's symptoms.

Conclusion:

In patients with ascites as the primary symptom, abdominal TB should be suspected, especially among those belonging to special population groups such as indigenous or older people.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000056
2015-06-01
2021-07-28
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/2/3/jmmcr000056.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000056&mimeType=html&fmt=ahah

References

  1. Alonso Renedo F.J, Casas Herrero A, Martínez Velilla N, Iráizoz Apezteguía I. 2011; [A 87-year-old woman with dyspnea, increased abdominal perimeter and increased disability]. Rev Esp Geriatr Gerontol 46:333–334 (in Spanish). [CrossRef]
    [Google Scholar]
  2. Aston N.O. 1997; Abdominal tuberculosis. World J Surg 21:492–499 [CrossRef]
    [Google Scholar]
  3. Belo E.N, Orellana JDY, Levino A, Basta P.C. 2013; [Tuberculosis in Amazonian municipalities of the Brazil-Colombia-Peru-Venezuela border: epidemiological situation and risk factors associated with treatment default]. Rev Panam Salud Publica 34:321–329 (in Portuguese).
    [Google Scholar]
  4. Bhigjee A.I, Padayachee R, Paruk H, Hallwirth-Pillay K.D, Marais S, Connoly C. 2007; Diagnosis of tuberculous meningitis: clinical and laboratory parameters. Int J Infect Dis 11:348–354 [CrossRef]
    [Google Scholar]
  5. Brant C.Q, Silva M.R Jr, Macedo E.P, Vasconcelos C, Tamaki N, Ferraz M.L. 1995; The value of adenosine deaminase (ADA) determination in the diagnosis of tuberculous ascites. Rev Inst Med Trop Sao Paulo 37:449–453 [CrossRef]
    [Google Scholar]
  6. Chalya P.L, McHembe M.D, Mshana S.E, Rambau P, Jaka H, Mabula J.B. 2013; Tuberculous bowel obstruction at a university teaching hospital in Northwestern Tanzania: a surgical experience with 118 cases. World J Emerg Surg 8:12 [CrossRef]
    [Google Scholar]
  7. Chou C.H, Ho M.W, Ho C.M, Lin P.C, Weng C.Y, Chen T.C, Chi C.Y, Wang J.H. 2010; Abdominal tuberculosis in adult: 10-year experience in a teaching hospital in central Taiwan. J Microbiol Immunol Infect 43:395–400 [CrossRef]
    [Google Scholar]
  8. Farías Llamas O.A, López Ramírez M.K, Morales Amezcua J.M, Medina Quintana M, Buonocunto Vázquez G, Ruiz Chávez I.E, González Ojeda A. 2005; [Peritoneal and intestinal tuberculosis: an ancestral disease that poses new challenges in the technological era. Case report and review of the literature]. Rev Gastroenterol Mex 70:169–179 (in Spanish)
    [Google Scholar]
  9. Hernández Sarmiento J.M, Dávila Osorio V.L, Martínez Sánchez L.M, Restrepo Serna L, Grajales Ospina D.C, Toro Montoya A.E, Arango Urrea V, Vargas Grisales N, Estrada Gómez M, other authors. 2013; Tuberculosis in indigenous communities of Antioquia, Colombia: epidemiology and beliefs. J Immigr Minor Health 15:10–16 [CrossRef]
    [Google Scholar]
  10. Hou W, Sanyal A.J. 2009; Ascites: diagnosis and management. Med Clin North Am 93:801–817 vii. [CrossRef]
    [Google Scholar]
  11. Kang S.J, Kim J.W, Baek J.H, Kim S.H, Kim B.G, Lee K.L, Jeong J.B, Jung Y.J, Kim J.S, other authors. 2012; Role of ascites adenosine deaminase in differentiating between tuberculous peritonitis and peritoneal carcinomatosis. World J Gastroenterol 18:2837–2843 [CrossRef]
    [Google Scholar]
  12. Khan R, Abid S, Jafri W, Abbas Z, Hameed K, Ahmad Z. 2006; Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians. World J Gastroenterol 12:6371–6375
    [Google Scholar]
  13. López Rodríguez R, Campos Franco J, Lado Lado F.L, Alende Sixto M.R, González Quintela A. 2004; [Tuberculous peritonitis: a Third World's disease?]. Med Interna 21:331–333 (in Spanish)
    [Google Scholar]
  14. Marx G.E, Chan E.D. 2011; Tuberculous meningitis: diagnosis and treatment overview. Tuberc Res Treat 2011:798764
    [Google Scholar]
  15. Pandit V, Valsalan R, Seshadri S, Bahuleyan S. 2009; Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report. Braz J Infect Dis 13:383–386 [CrossRef]
    [Google Scholar]
  16. Ray S, Talukdar A, Kundu S, Khanra D, Sonthalia N. 2013; Diagnosis and management of miliary tuberculosis: current state and future perspectives. Ther Clin Risk Manag 9:9–26 [CrossRef]
    [Google Scholar]
  17. Riquelme A, Calvo M, Salech F, Valderrama S, Pattillo A, Arellano M, Arrese M, Soza A, Viviani P, Letelier L.M. 2006; Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis. J Clin Gastroenterol 40:705–710 [CrossRef]
    [Google Scholar]
  18. Runyon B.A. 1994; Care of patients with ascites. N Engl J Med 330:337–342 [CrossRef]
    [Google Scholar]
  19. Sandgren A, Hollo V, van der Werf M.J. 2013; Extrapulmonary tuberculosis in the European Union and European Economic Area, 2002 to 2011. Euro Surveill 18:20431
    [Google Scholar]
  20. Sharma M.P, Bhatia V. 2004; Abdominal tuberculosis. Indian J Med Res 120:305–315
    [Google Scholar]
  21. Sharma S.K, Mohan A, Sharma A. 2012; Challenges in the diagnosis & treatment of miliary tuberculosis. Indian J Med Res 135:703–730 [CrossRef]
    [Google Scholar]
  22. Tan K.K, Chen K, Sim R. 2009; The spectrum of abdominal tuberculosis in a developed country: a single institution's experience over 7 years. J Gastrointest Surg 13:142–147 [CrossRef]
    [Google Scholar]
  23. Uzunkoy A, Harma M, Harma M. 2004; Diagnosis of abdominal tuberculosis: experience from 11 cases and review of the literature. World J Gastroenterol 10:3647–3649
    [Google Scholar]
  24. Vázquez Muñoz E, Barbado Hernández F.J, Atienza Saura M. 2003; [Computed tomography in the diagnosis of tuberculous peritonitis]. Rev Clin Esp 203:139–141 (in Spanish). [CrossRef]
    [Google Scholar]
  25. Zevallos M, Justman J.E. 2003; Tuberculosis in the elderly. Clin Geriatr Med 19:121–138 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.000056
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.000056
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error