Unusual presentation of a tuberculous peritonitis in a patient with concomitant AIDS and liver cirrhosis.
We report a case of tuberculous peritonitis in a patient with concomitant HIV infection and liver cirrhosis. A 50-year-old man with viral B and delta liver cirrhosis and AIDS was diagnosed with spontaneous Escherichia coli peritonitis and successfully treated with beta-lactamins. Three months later, ascites reappeared and Mycobacterium tuberculosis was identified in peritoneal fluid cultures. The triple antituberculosis regimen was adjusted to his level of liver failure but the patient died of hepatic encephalopathy. Concomitant HIV infection and liver cirrhosis favour tuberculous peritonitis but they also make its diagnosis extremely difficult. Considering the poor prognosis of this infection when untreated, tuberculous peritonitis should be systematically suspected in such patients.
Turner
L
L
Department of Medicine, Hôpital Ambroise Paré, Boulogne, France.
Dupont
C
C
Lesur
G
G
Barthod
F
F
Moreau
D
D
Rouveix
E
E
Dorra
M
M
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D018450:Disease Progression; D017809:Fatal Outcome; D018451:Homosexuality, Male; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents