Osterwalder P, Widmer M, Widmer U, Schulthess G
Departement für Innere Medizin, Universitätsspital Zürich.
Praxis (Bern 1994). 1998 Mar 4;87(10):355-60.
Because of deteriorating general health, weight loss of 5 kg and leftsided epigastric pain a 44 year old innkeeper was evaluated unsuccessfully for 1 month. Thereafter a protein- and lymphocyte-rich ascites developed. CT-scans revealed a thickened visceral peritoneum and multiple, marginally increased retroperitoneal lymph nodes. The history of the patient originating from former Jugoslavia was suspicious for inadequately treated tuberculous pericarditis. Hence this diagnosis tuberculous peritonitis became probable but for practical reasons could not be proven neither by biopsy nor by culture. Under probatory antituberculous treatment the patient's general condition improved rapidly, the ascites disappeared and initially elevated parameters for infection normalized.
由于总体健康状况恶化、体重减轻5公斤以及左侧上腹部疼痛,一名44岁的旅馆老板接受了1个月的评估,但未取得成功。此后出现了富含蛋白质和淋巴细胞的腹水。CT扫描显示内脏腹膜增厚,腹膜后淋巴结多处轻度增大。该患者来自前南斯拉夫,其病史怀疑有结核性心包炎治疗不充分。因此,结核性腹膜炎的诊断成为可能,但出于实际原因,活检和培养均无法证实。在试验性抗结核治疗下,患者的一般状况迅速改善,腹水消失,最初升高的感染指标恢复正常。