A case of tuberculous peritonitis accompanied by tuberculous pleuritis

Larasati A. Wahyu, Pramarta Y. Dwiputra
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Abstract

Tuberculous peritonitis is a form of extrapulmonary tuberculosis, a peritoneal or visceral inflammation caused by Mycobacterium tuberculosis. The disease is rarely independent, but is usually a continuation of the tuberculosis process elsewhere, especially pulmonary tuberculosis. We report a case of TB peritonitis accompanied by TB pleurisy, a 29-year-old female patient with complaints of an enlarged abdomen, heartburn, fever, diarrhea, and decreased appetite. Treatment history was Acitral, Zinc, and Metronidazole. On physical examination, it was found that the general condition was weak and the axilla temperature was 39.5ºC. Thorax examination; decreased vesicular sound on the left chest. Abdominal examination; found distension, epigastric tenderness, undulation, shifting dullness, checkerboard phenomenon, and increased bowel noise. Laboratory examination of complete blood; within normal limits. Complete stool; yellow color, mucus (+), leukocytes 4-6/LPB, bacteria (+). The thorax photo showed left pleural effusion, BOF 3 position: ascites. Abdominal ultrasound results: thickening of the peritoneum, ascites, suspected TB peritonitis. Results of ascites and pleural fluid analysis: rivalta (+) and Adenosine Deaminase (ADA) increased. So that from anamnesis, physical examination, supporting examination can be established diagnosis of TB Peritonitis and TB Pleuritis, followed by OAT therapy; FDC for 12 months. From this case it can be concluded that clinical and supporting examinations (radiology) are needed to make a correct diagnosis and body fluid analysis examinations can help confirm the diagnosis.
一例结核性腹膜炎伴结核性胸膜炎病例
结核性腹膜炎是肺外结核病的一种形式,是由结核分枝杆菌引起的腹膜或内脏炎症。这种疾病很少是独立的,通常是其他部位结核病过程的延续,尤其是肺结核。我们报告了一例结核性腹膜炎伴结核性胸膜炎的病例,患者是一名 29 岁的女性,主诉腹部肿大、胃灼热、发热、腹泻和食欲减退。治疗史为阿奇霉素、锌和甲硝唑。体格检查发现,患者全身乏力,腋窝温度为 39.5 摄氏度。胸部检查:左胸水泡音减弱。腹部检查;发现腹胀、上腹压痛、起伏、移位迟钝、棋盘格现象和肠鸣音增加。全血实验室检查;在正常范围内。大便完整;黄色,粘液(+),白细胞 4-6/LPB,细菌(+)。胸部照片显示左侧胸腔积液,BOF 3 位置:腹水。腹部超声波检查结果:腹膜增厚,腹水,疑似结核性腹膜炎。腹水和胸水分析结果:rivalta(+)和腺苷脱氨酶(ADA)升高。因此,根据病史、体格检查和辅助检查,可以确诊为结核性腹膜炎和结核性胸膜炎,随后接受 OAT 治疗;FDC 治疗 12 个月。从这个病例中可以得出结论,要做出正确的诊断,需要进行临床和辅助检查(放射学),体液分析检查有助于确诊。
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