The diagnostic role of ascitic fluid adenosine deaminase activity in a peritoneal tuberculosis case presenting with abdominal pain and diarrhea

Abstract

A young case diagnosed with peritoneal tuberculosis with ascites will be presented here. Conditions that may pose a significant risk for the development of tuberculous peritonitis; poor hygiene, overpopulation, consumption of unpasteurized milk, cirrhosis, peritoneal dialysis, HIV infection, drug abuse and inadequate access to healthcare. In general, the tuberculosis agent reaches the gastrointestinal system via hematogenous route, ingestion of infected sputum, or direct spread. Peritoneal TB should be considered in the differential diagnosis in patients with abdominal pain, diarrhea, weight loss, anorexia, night sweats, presence of ascitic fluid, bilateral pleural effusion, pleural nodule appearance, and findings suggestive of peritonitis carcinomatosis, as in our case. Peritoneal tuberculosis is rarely diagnosed, without a high index of suspicion for this disease.

Keywords

• Tuberculose
• ascites
• adenosine deaminase

Karın ağrısı ve diyare ile başvuran peritoneal tüberküloz olgusunda asit sıvısı adenozin deaminaz aktivitesinin tanısal rolü

Abstract

Assiti bulunan periton tüberkülozu tanısı alan genç bir vaka burada sunulacaktır. Tüberküloz peritonit gelişimi için önemli risk oluşturabilecek durumlar arasında; kötü hijyen, aşırı nüfus, pastörize edilmemiş süt tüketimi, siroz, periton diyalizi, HIV enfeksiyonu, uyuşturucu kullanımı ve sağlık hizmetlerine yetersiz erişim bulunmaktadır. Genelde tüberküloz ajanı, gastrointestinal sisteme hematojen yolla, enfekte balgam yutulmasıyla veya doğrudan yayılma yoluyla ulaşır. Karın ağrısı, ishal, kilo kaybı, iştahsızlık, gece terlemeleri, asit sıvısı varlığı, bilateral plevral efüzyon, plevral nodül görünümü ve olgumuzda olduğu gibi peritonit karsinomatozunu düşündüren bulguları olan hastalarda ayırıcı tanıda peritoneal TB akla gelmelidir. Periton tüberkülozu, yüksek bir şüphe indeksi olmaksızın nadiren teşhis edilir.

Keywords

• Tüberküloz
• Assit
• Adenozin Deaminaz

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