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CASE REPORT
Massive infected ascites in an immunocompetent patient with gastrointestinal tuberculosis
  1. Carmegie C Saliba1,
  2. Isabelle Dominique Villegas Tomacruz1,
  3. Mary Louise Margaret M Javier2 and
  4. Homer Co3
  1. 1 Department of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines
  2. 2 College of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines
  3. 3 Section of Adult Medicine, Department of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines
  1. Correspondence to Dr Carmegie C Saliba, ccsaliba{at}up.edu.ph

Abstract

Mycobacterium tuberculosisis highly endemic in the Philippines. The diagnosis is challenging with its non-specific presentation and the organism could extend to any of the organs. Interestingly, bacterial peritonitis arising spontaneously from gastrointestinal tuberculosis (TB) in an otherwise healthy, non-cirrhotic patient is quite unusual. In this paper, we discuss the case of a 27-year-old HIV-seronegative woman with massive intraperitoneal mixed bacterial and tuberculous abscess presenting 20 months after being diagnosed with bacteriologically confirmed gastrointestinal TB. Repeated large-volume paracentesis was done to drain out the infected ascites instead of inserting a percutaneously implanted catheter. Clinical improvement was noted and she was discharged after 12 days of intravenous antibiotics. She had completed 6 months of antituberculosis therapy and been well since then. The case has demonstrated that repeated paracentesis along with appropriate antibiotic regimen, may be a viable option for patients with TB and bacterial coinfected peritonitis. And possibly, peritoneal TB may increase the risk for (spontaneous) bacterial peritonitis.

  • infections
  • ib and other respiratory infections
  • infection (gastroenterology)
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Footnotes

  • Contributors CCS was the primary physician who managed the patient. She wrote the draft for this case report and consolidate inputs of all involved services. HC was the consultant-in-charge of this case and he directly supervise in the management and writing of this manuscript. IDVT and MLMMJ were actively engaged in the management of the patient. They both assisted in the editing of this manuscript. All authors are accountable in the integrity and accuracy of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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