title: Tuberculous peritonitis in cirrhotic patients: comparison of spontaneous bacterial peritonitis caused by Escherichia coli with tuberculous peritonitis.
abstract: The aim of this study was to compare the characteristics of tuberculous peritonitis (TP) and spontaneous bacterial peritonitis (SBP) in cirrhotic patients. In a retrospective review of the medical records of a single tertiary hospital between 1988 and 2006, 15 patients met the diagnostic criteria TP and liver cirrhosis. For comparison, we randomly selected 3 cirrhotic patients with SBP caused by Escherichia coli for each cirrhotic patient with TP. Compared to SBP, TP in cirrhotic patients was more frequently associated with extra-peritoneal tuberculosis (TP vs SBP: 53.3% vs 0%), an insidious onset (> or =2 weeks; 60% vs 2.2%), and Child-Pugh classification class B at onset (80% vs 8.9%) (p<0.05). Compared to SBP, TP was associated with lower white blood cell count in ascites (TP vs SBP: 2.0+/-2.2 x 10(3)/mm(3) vs 7.2+/-7.5 x 10(3)/mm(3)), a higher proportion of mononuclear leukocytes (lymphocytes and monocytes) in ascites (88.9+/-9.5% vs 16.6+/-15.3%), higher protein concentration in ascites (3.1+/-1.7 g/dl vs 1.2+/-0.3 g/dl), and higher adenosine deaminase activity in ascites (62.3+/-31.8 U/l vs 6.9+/-3.1 U/l) (p<0.05). TP should be suspected in cirrhotic patients with relevant clinical manifestations and characteristics of ascites.
authors.affiliation: Department of Infectious Disease, Asan Medical Centre, University of Ulsan College of Medicine, Centre for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Choo
authors.forename: Yee Gyung
authors.initials: YG
authors.lastname: Kwak
authors.forename: Sang Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry / Q000166:cytology; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications / Q000382:microbiology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000097:blood / Q000150:complications / Q000382:microbiology*; D014395:Peritonitis, Tuberculous / Q000097:blood / Q000150:complications / Q000382:microbiology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric