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.
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 − 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.
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.
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