Sputum culture before the treatment was positive for MTB Four mo

Sputum culture before the treatment was positive for MTB. Four months after the initiation of the treatment, her hemoglobin and

CA-125 levels turned to normal. The ascites had disappeared, the diameters of the LAPs had significantly decreased, and the symptoms of the patient had all regressed. TB is an important health problem for developing countries. Since the symptoms, laboratory and physical findings are not specific, the diagnosis of extrapulmonary TB is difficult. The most common symptoms in TB peritonitis are abdominal pain, fever, weight loss, and abdominal distention [6]. Ascites is usually seen in the physical examination of peritoneal TB [7] and [8]. Similarly, our patient had ascites, abdominal pain, and weight loss. TB peritonitis is usually associated

with pulmonary TB [9]. TB peritonitis selleck screening library may present itself as disseminated TB. More than fifty percent of pulmonary TB has reported with TB peritonitis [10] and [11]. Yeh et al. reported that 77% of patients with TB peritonitis had abnormalities in chest radiographs [10]. Our patient’s chest X-ray was abnormal but not specific for TB. In the literature, ascites, LAP, peritoneal, and mesenteric thickness are the most common findings in CT and USG scans of peritoneal TB, which has a low sensitivity and specificity [8] and [12]. The abdominal CT of our patient showed similar findings with that of the literature (Fig. 2A). CA-125 levels usually increase in PF-01367338 tumors (epithelial over, endometrium, fallopian tubes, myometrium and non-gynecologic) and occasionally in TB peritonitis [13]. TB peritonitis rarely mimics tumors with high CA-125, so patients may undergo laparatomy [14]. Our patient had a high CA-125 level (901,1 U/ml) which became normal after the treatment stated in the literature [15]. FGTB can be seen with postmenopausal gynecological malignancies [16]. In postmenopausal women, genital TB is rare and endometrium is the most affected site (60–70%). FGTB is usually Dimethyl sulfoxide found in young patients diagnosed with infertility [17]. A microbiological culture of endometrial curretage for

MTB and/or the histological appearance of granulomas, with or without caseation in curretage material, can verify the diagnosis [4]. Histopathological examination of our patient’s endometrial curretage material revealed granulomas with caseation (Fig. 2B). A high lymphocyte count, elevated LDH and total protein, decreased glucose level, ADA levels (>35 IU/L) in ascitic fluid, and a SAAG of less than 1.1 g/dl have been used as helpful diagnostic tests for TB peritonitis [10]. In our case, SAAG was <1.1 g/dL, and ascitic fluid LDH, ADA were 281 U/L, 60.4 U/L, respectively. The Positive Mantoux test result was 80% specific and 55% sensitivity for the diagnosis of TB [18]. In our case PPD was also positive. The distinctive feature in the case of our patient is that both pulmonary and genital TB were diagnosed at the same time.

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