Massive infected ascites in an immunocompetent patient with gastrointestinal tuberculosis.
| Autor: | Saliba CC; Department of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines., Tomacruz IDV; Department of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines., Javier MLMM; College of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines., Co H; Section of Adult Medicine, Department of Medicine, University of the Philippines Manila, Manila, Metro Manila, Philippines. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2019 Aug 26; Vol. 12 (8). Date of Electronic Publication: 2019 Aug 26. |
| DOI: | 10.1136/bcr-2019-230794 |
| Abstrakt: | Mycobacterium tuberculosis is 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. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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