Tuberculosis peritonitis in Negara Brunei Darussalam.
BACKGROUND
Tuberculosis peritonitis (TBP) is uncommon and symptoms can be non-specific. Local data are lacking and our aim is to review our local experience with TBP.


METHODS
Between the period of 1996 to 2004, there were 10 [male: 6; mean age, 48 +/- 18.5 years (range, 26 to 73)] cases of histologically documented TBP. Comparisons were made with pulmonary tuberculosis (PTB) patients.


RESULTS
The overall prevalence ranged from 0% to 1.01% of all TB infections. The median duration of symptoms before diagnosis was 2 months (range, 3 days to 24 months). Five patients (50%) had comorbid conditions and 3 patients (30%) had a history of positive contact. Presenting symptoms were abdominal distension (70%), abdominal pain (60%), fever (60%), anorexia (60%) and weight loss (40%). Two patients had pulmonary symptoms: cough/dyspnoea (n = 1) and cough (n = 1). Chest x-ray changes consistent with PTB were seen in 30%. TBP was diagnosed by laparoscopy (n = 6), laparotomy (n = 3) and blind peritoneal biopsy (n = 1). Adverse effects of TB drugs occurred in 80%, consisting of hepatitis (n = 4), nausea/vomiting (n = 2), rash (n = 1) and encephalopathy (n = 1). Haemoglobin (P = 0.026) and serum albumin levels (P = 0.002) were significantly lower in TBP patients. There was a significantly greater number of adverse effects (P <0.001). There were no significant differences between TBP and PTB with regard to age, non-specific symptoms (weight loss, anorexia and fever) and erythrocyte sedimentation rate. All were treated with standard regimes and there were no mortalities.


CONCLUSIONS
TBP is uncommon in our population. TBP patients had significantly lower haemoglobin and serum albumin levels. They also experienced more adverse events during treatment. There were no differences in non-specific symptoms between TBP and PTB.
Chong
V H
VH
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Negara Brunei Darussalam. chongvuih@yahoo.co.uk
Rajendran
N
N
D000328:Adult; D000368:Aged; D002010:Brunei; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology