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Indigenous people tend to have higher incidence of Mycobacterium tuberculosis infection (TB). The diagnosis of TB is a challenge among older patients because of its non-specific presentation, especially for cases of extrapulmonary TB.
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 − 1.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.
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.
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