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Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient

A 36-year-old man with no significant past medical history presented with two-month abdominal distention, night sweats, and weight loss of 15 Ib. He had no known exposure to tuberculosis. PPD test was negative prior to the hospital admission. Physical examination was notable for new onset ascites, b...

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Autores principales: Tomizawa, Yutaka, Yecies, Emmanuelle B., Craig, Fiona E., Sohnen, Adam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710623/
https://www.ncbi.nlm.nih.gov/pubmed/23878749
http://dx.doi.org/10.1155/2013/680763
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author Tomizawa, Yutaka
Yecies, Emmanuelle B.
Craig, Fiona E.
Sohnen, Adam
author_facet Tomizawa, Yutaka
Yecies, Emmanuelle B.
Craig, Fiona E.
Sohnen, Adam
author_sort Tomizawa, Yutaka
collection PubMed
description A 36-year-old man with no significant past medical history presented with two-month abdominal distention, night sweats, and weight loss of 15 Ib. He had no known exposure to tuberculosis. PPD test was negative prior to the hospital admission. Physical examination was notable for new onset ascites, but no superficial lymphadenopathy or stigmata of chronic liver disease was found. CT scan demonstrated enlarged mesenteric lymph nodes, and prominent retroperitoneal lymph nodes along with moderate ascites and omental infiltration. Diagnostic paracentesis yielded WBC of 295/mm(3), lymphocytic predominance (70%), and serum ascitic albumin gradient of 0.1, consistent with exudate. Both the ascitic culture and AFB smear were negative, and ascitic cytology revealed nonmalignant cells. Exploratory laparoscopy for excisional biopsy of mesenteric lymph nodes was performed. Pathologic findings revealed caseous granulomas with scattered multinucleated giant cells. Mesenteric lymph node tissue culture subsequently grew Mycobacterium tuberculosis complex and the diagnosis of peritoneal tuberculosis was confirmed. The patient was started on quadruple therapy. A couple of days after the antibiotics were started, the small bowel obstruction started to resolve with resumption of bowel movements and tolerance of oral intake. A week later, ascites stopped accumulating and fever was no longer noted. He has been well and continues to be under observation.
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spelling pubmed-37106232013-07-22 Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient Tomizawa, Yutaka Yecies, Emmanuelle B. Craig, Fiona E. Sohnen, Adam Case Rep Gastrointest Med Case Report A 36-year-old man with no significant past medical history presented with two-month abdominal distention, night sweats, and weight loss of 15 Ib. He had no known exposure to tuberculosis. PPD test was negative prior to the hospital admission. Physical examination was notable for new onset ascites, but no superficial lymphadenopathy or stigmata of chronic liver disease was found. CT scan demonstrated enlarged mesenteric lymph nodes, and prominent retroperitoneal lymph nodes along with moderate ascites and omental infiltration. Diagnostic paracentesis yielded WBC of 295/mm(3), lymphocytic predominance (70%), and serum ascitic albumin gradient of 0.1, consistent with exudate. Both the ascitic culture and AFB smear were negative, and ascitic cytology revealed nonmalignant cells. Exploratory laparoscopy for excisional biopsy of mesenteric lymph nodes was performed. Pathologic findings revealed caseous granulomas with scattered multinucleated giant cells. Mesenteric lymph node tissue culture subsequently grew Mycobacterium tuberculosis complex and the diagnosis of peritoneal tuberculosis was confirmed. The patient was started on quadruple therapy. A couple of days after the antibiotics were started, the small bowel obstruction started to resolve with resumption of bowel movements and tolerance of oral intake. A week later, ascites stopped accumulating and fever was no longer noted. He has been well and continues to be under observation. Hindawi Publishing Corporation 2013 2013-06-26 /pmc/articles/PMC3710623/ /pubmed/23878749 http://dx.doi.org/10.1155/2013/680763 Text en Copyright © 2013 Yutaka Tomizawa et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Tomizawa, Yutaka
Yecies, Emmanuelle B.
Craig, Fiona E.
Sohnen, Adam
Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title_full Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title_fullStr Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title_full_unstemmed Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title_short Peritoneal Tuberculosis in an Immunocompetent, Unknown Risk Patient
title_sort peritoneal tuberculosis in an immunocompetent, unknown risk patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710623/
https://www.ncbi.nlm.nih.gov/pubmed/23878749
http://dx.doi.org/10.1155/2013/680763
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