Sen Dilek, Brunton Joshua, Melchior Landon, Klein David, Levy Gillian H, Wainscoat Booth, Chuang Linus
Ross University School of Medicine, Miramar, Florida, USA.
Department of Obstetrics and Gynecology, Danbury Hospital, Danbury, Connecticut, USA.
Case Rep Womens Health. 2020 Oct 20;28:e00264. doi: 10.1016/j.crwh.2020.e00264. eCollection 2020 Oct.
Peritoneal tuberculosis (TB) is a rare extrapulmonary manifestation of TB with non-specific clinical characteristics which can produce test results mimicking malignancy and granulomatous peritonitis. This case describes a Filipino 59-year-old, nulliparous woman who was admitted with abdominal pain, ascites, and an elevated CA-125 level. Radiographically, peritoneal nodules were visualized and initial suspicion was high for malignancy. Following a bilateral salpingo-oophorectomy and peritoneal biopsy, histology was negative for malignancy but revealed non-caseating granulomas. She was discharged then readmitted with progressive abdominal pain, and a repeat laparoscopic biopsy yielded specimens with growth of acid-fast bacilli (AFB). A delay in diagnosis and treatment of tuberculous peritonitis increases mortality rates, making early diagnosis with laparoscopic biopsy of paramount importance in prompt diagnosis and initiation of therapy. This patient was initiated on standard anti-TB therapy and experienced no complications.
腹膜结核是结核病一种罕见的肺外表现，具有非特异性临床特征，其检查结果可能类似恶性肿瘤和肉芽肿性腹膜炎。本病例描述了一名59岁未生育的菲律宾女性，因腹痛、腹水和CA-125水平升高入院。影像学检查可见腹膜结节，最初高度怀疑为恶性肿瘤。在进行双侧输卵管卵巢切除术和腹膜活检后，组织学检查排除恶性肿瘤，但发现了非干酪样肉芽肿。她出院后因进行性腹痛再次入院，再次腹腔镜活检获得的标本培养出抗酸杆菌（AFB）。结核性腹膜炎的诊断和治疗延迟会增加死亡率，因此腹腔镜活检对于早期诊断以及及时诊断和开始治疗至关重要。该患者开始接受标准抗结核治疗，未出现并发症。
