Oppong Bright, Gyabaah Solomon, Amponsah Gorden Manu, Quansah Ato, Darkwa Eric Amoako
Komfo Anokye Teaching Hospital Kumasi Ghana.
School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana.
Clin Case Rep. 2024 Mar 8;12(3):e8617. doi: 10.1002/ccr3.8617. eCollection 2024 Mar.
The clinical manifestations of peritoneal tuberculosis are quite variable, nonspecific and mimic many diseases and pathological conditions such as lymphoma, and ovarian malignancy. Due to this clinical overlap and limited accuracy of diagnostic tests, more awareness of this disease is required to enable early diagnosis and prompt treatment. This is a case of a 25-year-old female with no known chronic illness who presented with worsening generalized abdominal pains and distension of 2 months duration. There was an associated significant weight loss of 17 kg. She was initially diagnosed with ovarian malignancy based of ultrasound findings and elevated CA-125 levels. However, further evaluation later was consistent with peritoneal tuberculosis for which she was treated. Her symptoms resolved completely after 6 months of anti-tuberculosis treatment. Diagnosis of abdominal TB remains challenging as it is non-specific. Its features and clinical manifestation overlap with other conditions such as ovarian malignancy. A high index of suspicions and judicious application of the available diagnostic test is need for prompt diagnosis. No single test can effectively diagnose peritoneal TB, but a combination of history, and radiological, immunologic, molecular, and cytologic tests are important.
腹膜结核的临床表现差异很大,缺乏特异性,可模仿多种疾病和病理状况,如淋巴瘤和卵巢恶性肿瘤。由于这种临床重叠以及诊断检查的准确性有限,需要提高对该疾病的认识,以便早期诊断和及时治疗。这是一例25岁女性患者,无已知慢性病,出现进行性加重的全腹痛和腹胀2个月。伴有体重显著减轻17千克。最初根据超声检查结果和CA-125水平升高诊断为卵巢恶性肿瘤。然而,后来的进一步评估结果与腹膜结核相符,并对其进行了治疗。抗结核治疗6个月后,她的症状完全缓解。腹部结核的诊断仍然具有挑战性,因为其缺乏特异性。其特征和临床表现与卵巢恶性肿瘤等其他疾病重叠。需要高度的怀疑指数并明智地应用现有诊断检查以进行及时诊断。没有单一的检查能够有效诊断腹膜结核,但病史、放射学、免疫学、分子学和细胞学检查相结合很重要。