Tuberculous peritonitis in Manitoba.

Between Jan. 1, 1971 and June 30, 1976 the authors diagnosed tuberculous peritonitis in 17 patients. The basis for the diagnosis was a positive culture for Mycobacterium tuberculosis from the peritoneal fluid or nodules (nine patients) or the presence of caseating granulomas in biopsy specimens of the peritoneum (eight patients). Fifteen of the 17 patients were women. Eleven were North American Indians and eight of them suffered from alcoholism. The predominant symptoms of abdominal pain, progressive abdominal distension and vomiting, and abdominal tenderness on physical examination were present both in alcoholics and in nonalcoholics. However, only the former had demonstrable ascites. The mean time from admission to hospital until establishment of the diagnosis was 8.3 days in six nonalcoholics and 49 days in the alcoholics (P less than 0.01). The delay in making the diagnosis in the patients with alcoholism resulted from a tendency to attribute their fever to alcoholic hepatitis and the ascites to portal hypertension. The mean duration of hospitalization was 160.3 days for the alcoholics and only 41.5 days for the nonalcoholics. Two of the eight alcoholics died, one of hepatic failure and the other, 3 years after the diagnosis of tuberculous peritonitis was made, of miliary tuberculosis.