title: Tuberculous peritonitis developing during chemotherapy for pulmonary and intestinal tuberculosis: a case report.
abstract: This report is of a case of tuberculous peritonitis that developed during antituberculous chemotherapy. A 54-year-old man had been diagnosed as all-drug susceptible pulmonary and intestinal tuberculosis, and treatment with isoniazid, ethambutol and rifampicin had been initiated. About 5 months later, while still undergoing therapy, a large amount of ascites developed. A diagnostic laparoscopy was performed but due to the adhesion between the greater omentum and the parietal peritoneum, intestinal perforation occurred. An emergency operation was performed and the diagnosis of tuberculous peritonitis was confirmed. There are few reports of abdominal tuberculosis developing during antituberculous chemotherapy. In this case a paradoxical response may have been involved in the pathogenesis.
authors.affiliation: Second Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan. kassan@naramed-u.ac.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Kasahara
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Fukuoka
authors.forename: Koichi
authors.initials: K
authors.lastname: Murakawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Mikasa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Narita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
mesh_terms: D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012293:Rifampin / Q000627:therapeutic use; D013997:Time Factors; D014385:Tuberculosis, Gastrointestinal / Q000150:complications* / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
chemical_list: D000904:Antibiotics, Antitubercular; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin