Background: Peritoneal involvement is a relatively rare complication of tuberculosis, accounting
for approximately 3.3% of extrapulmonary disease in the United States. Clinical diagnosis
relies on a preponderance of indirect evidence and is often delayed. We describe such
a patient.
Methods: An otherwise healthy 15-month-old male presented with fever, abdominal distention,
vague abdominal pains, and a few episodes of watery diarrhea. Standard laboratory
and radiologic work-up was unrevealing, and after a prolonged hospitalization, caseating
granulomas were identified at diagnostic laparotomy.
Results: Definitive treatment was further delayed pending culture results, and the patient's
condition worsened until fulminant cardiovascular collapse led to his demise.
Conclusions: Despite effective chemotherapeutic regimens, the overall mortality of tuberculous
peritonitis may be as high as 51%. The diagnosis must be considered and empiric antituberculous
treatment started early in the course of the disease, even if definitive diagnosis
is still pending.
