Turner L, Dupont C, Lesur G, Barthod F, Moreau D, Rouveix E, Dorra M
Department of Medicine, Hôpital Ambroise Paré, Boulogne, France.
Eur J Gastroenterol Hepatol. 1996 Oct;8(10):1021-2. doi: 10.1097/00042737-199610000-00017.
We report a case of tuberculous peritonitis in a patient with concomitant HIV infection and liver cirrhosis. A 50-year-old man with viral B and delta liver cirrhosis and AIDS was diagnosed with spontaneous Escherichia coli peritonitis and successfully treated with beta-lactamins. Three months later, ascites reappeared and Mycobacterium tuberculosis was identified in peritoneal fluid cultures. The triple antituberculosis regimen was adjusted to his level of liver failure but the patient died of hepatic encephalopathy. Concomitant HIV infection and liver cirrhosis favour tuberculous peritonitis but they also make its diagnosis extremely difficult. Considering the poor prognosis of this infection when untreated, tuberculous peritonitis should be systematically suspected in such patients.
我们报告一例合并人类免疫缺陷病毒（HIV）感染和肝硬化的结核性腹膜炎患者。一名50岁男性，患有乙型和丁型病毒性肝硬化及艾滋病，被诊断为自发性大肠杆菌腹膜炎，并接受β-内酰胺类药物成功治疗。三个月后，腹水再次出现，腹膜液培养中发现结核分枝杆菌。三联抗结核治疗方案根据其肝功能衰竭程度进行了调整，但患者最终死于肝性脑病。HIV感染和肝硬化并存易引发结核性腹膜炎，同时也使其诊断极具难度。鉴于这种感染若不治疗预后较差，对此类患者应系统性怀疑结核性腹膜炎。
