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Year : 2018  |  Volume : 2  |  Issue : 1  |  Page : 3-7

Peritoneal tuberculosis: Advances and controversies

Department of Medicine, Hamad General Hospital, Doha, Qatar

Correspondence Address:
Dr. Fahmi Yousef Ahmed Khan
Department of Medicine, Hamad General Hospital, Doha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/LJMS.LJMS_35_17

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Peritoneal tuberculosis (TB) remains a public health problem especially in the developing countries, even in the developed countries, where the disease had been mostly controlled; it poses a new challenge for health-care facilities as a result of increased immigration from high prevalence area, the use of more potent immunosuppressive therapy and the acquired immunodeficiency syndrome epidemic. The diagnosis of peritoneal TB is often challenging and cannot be made or excluded on the basis of clinical findings, which are quite protean and nonspecific. Blood biochemistry, complete blood cell count, and radiographic studies are of limited diagnostic value. Acid-fast smear of ascitic fluid has a low yield and cultures require weeks to give results and are positive in 2%–50% of diagnosed cases. Polymerase chain reaction analysis for rapid detection of bacillus tubercles in ascitic fluid has low yield, and the role of other biomarkers such as adenosine deaminase and gamma interferon is less well described and currently being evaluated as diagnostic tools. Laparoscopy with directed biopsy provides a rapid and correct diagnosis in 76%–100% of cases and should be performed early in suspected cases. Six-month therapy with the 4-drug regimen is effective in most of the patients, while the role of adjunctive corticosteroid therapy remains controversial.

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