Tuberculous peritonitis

Abstract

Although the general incidence of peritonitis has declined considerably with improvement in connectology, tuberculous peritonitis is still a major problem in patients who are from endemic regions and who belong to high-risk groups. The problem stems mainly from less sensitive diagnostic tools. Confirmation of tuberculous peritonitis is based on mycobacterial culture of the peritoneal fluid, which takes a few weeks. For patients in whom tuberculous peritonitis cannot be confirmed, therapeutic trial has been recommended. Treatment of tuberculous peritonitis consists in removing the peritoneal catheter and initiating antituberculosis medications, though the dosage and duration of antituberculosis medication are not yet well defined. Early initiation of antituberculosis medication has been shown to preserve good ultrafiltration and solute clearance by the peritoneal membrane.