A rare case of peritoneal tuberculosis mimicking peritoneal carcinomatosis: the ongoing challenge.

Publication date: Oct 10, 2024

Tuberculosis (TB) is a serious infection that can involve any organ system and present in various forms. About one-third of the world’s population are carriers of latent TB. Although most cases are from a pulmonary origin, there is a rising prevalence of abdominal TB. Patients with pulmonary or extrapulmonary TB are treated similarly through the use of pharmacological therapy. Nonspecific clinical manifestations of TB have made it difficult for clinicians to diagnose. Peritoneal tuberculosis (PTB) is a serious concern as its symptoms overlap with that of many other chronic conditions, especially in those who are immunocompromised. The lack of highly sensitive and specific testing methods has made early intervention difficult, therefore a high index of suspicion is crucial in the progression of the disease. Here, we present a case of a 71-year-old female with a history of abdominal pain, fever, and weakness. Initial investigation with computed tomography (CT) imaging revealed omental fat stranding that pointed towards peritoneal carcinomatosis (PC) from possible recurrence of her ovarian cancer. Further investigation with a peritoneal biopsy was remarkable for caseating granulomas with fat necrosis confirming extrapulmonary TB. This report highlights a rare case of PTB mimicking PC in an elderly patient who is immunocompromised from the use of long-term corticosteroids who continued to decline after pharmacological treatment of the disease.

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Concepts Keywords
Carcinomatosis CA-125
Long Case report
Organ Ovarian cancer
Pharmacological Peritoneal carcinomatosis
Tuberculosis Peritoneal tuberculosis

Semantics

Type Source Name
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH peritoneal carcinomatosis
disease MESH infection
disease MESH chronic conditions
disease IDO intervention
disease IDO history
disease MESH recurrence
disease MESH ovarian cancer
disease MESH granulomas
disease MESH fat necrosis
pathway REACTOME Reproduction
disease MESH Infectious Diseases
disease MESH Liver cirrhosis
disease MESH diabetes mellitus
disease MESH malnutrition
disease MESH malignancies
disease MESH ascites
drug DRUGBANK Coenzyme M
drug DRUGBANK Cortisone
disease MESH adrenal insufficiency
drug DRUGBANK Hydrocortisone
disease MESH hypertension
disease MESH emergency
disease MESH pneumonia
disease MESH phlegmon
disease MESH carcinomatosis
drug DRUGBANK L-Leucine
drug DRUGBANK Oxygen
disease IDO blood
drug DRUGBANK Potassium
drug DRUGBANK Alkaline Phosphatase
disease MESH urinary tract infection
disease MESH pleural effusions
disease MESH anasarca
disease MESH metastasis
disease MESH bacterial pneumonia
disease MESH hospital acquired pneumonia
drug DRUGBANK Vancomycin
drug DRUGBANK Cefepime
drug DRUGBANK Metronidazole
disease IDO bacteria
disease MESH pulmonary edema
disease MESH etiology
disease MESH peritoneal fluid
drug DRUGBANK p-Phenylenediamine
drug DRUGBANK Ademetionine
drug DRUGBANK Silver
disease IDO assay
disease MESH morbidities
disease IDO nucleic acid
drug DRUGBANK Rifampicin
drug DRUGBANK Isoniazid
drug DRUGBANK Pyrazinamide
disease MESH complications
disease MESH gout
disease MESH hyperuricemia
disease MESH hypothyroidism
disease MESH severe sepsis
disease IDO country
disease MESH latent infection
disease IDO cell
disease MESH inflammation
drug DRUGBANK Trestolone
disease MESH pulmonary tuberculosis
disease MESH death
disease IDO immunodeficiency
disease MESH Extrapulmonary Tuberculosis
drug DRUGBANK Spinosad

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