Tuberculous peritonitis: Analysis of 211 cases in Taiwan

• Published in: Digestive and liver disease Vol. 44; no. 2; pp. 111 - 117
• Main Authors: Yeh, Hsiu-Fen, Chiu, Te-Fa, Chen, Jih-Chang, Ng, Chip-Jin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2012
• Subjects: Adult; Aged; Delayed Diagnosis; Diagnosis, Differential; Female; Follow-Up Studies; Gastroenterology and Hepatology; Humans; Incidence; Male; Middle Aged; Mycobacterium tuberculosis; Mycobacterium tuberculosis - isolation & purification; Peritoneal tuberculosis; Peritoneum - microbiology; Peritonitis, Tuberculous - diagnosis; Peritonitis, Tuberculous - epidemiology; Peritonitis, Tuberculous - microbiology; Prevalence; Retrospective Studies; Secondary bacterial peritonitis; Taiwan - epidemiology; Time Factors; Tuberculosis; Taiwan; Secondary bacterial peritonitis; Peritoneal tuberculosis; Tuberculosis; Mycobacterium tuberculosis
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2011.08.020

Abstract Background Tuberculosis infection caused by Mycobacterium tuberculosis or other Mycobacterium species is a major communicable disease worldwide. Aim We evaluated the epidemiology of tuberculous peritonitis to determine diagnostic features and factors related to late diagnosis. Methods We retrospectively reviewed 211 tuberculous peritonitis cases diagnosed between January 1999 and December 2009. Clinical features, laboratory data, and diagnostic methods were analysed. Results Subjects included 115 males (54.5%) and 96 females (45.5%) with median age 61.0 years (range 43–72) and 29.2 days mean duration from symptoms to diagnosis. Disease histories included end-stage renal disease (20.9%), pulmonary tuberculosis (36.0%) and liver cirrhosis (23.7%). Most common symptoms were abdominal distension (80.1%), abdominal pain (68.7%) and weight loss (45.5%). Most common signs were ascites (62.6%) and fever (55.5%). One-year survival rate was 89.9%; 21 patients died during follow-up. Mortality risk was higher in patients with more concomitant diseases, including liver cirrhosis, AIDS, chronic steroid use, alcoholism, GI bleeding, haemoptysis, period from symptom presentation to treatment, secondary bacterial peritonitis requiring emergent operation. Conclusions Increased duration between symptoms and definitive diagnosis increases mortality risk. Early diagnosis and prompt initiation of anti-tuberculosis therapy improve prognosis. Neutrophil-predominant ascites influences poor prognosis when correlated with secondary bacterial peritonitis.