title: Tuberculous peritonitis: analysis of 211 cases in Taiwan.
abstract: BACKGROUND
  Tuberculosis infection caused by Mycobacterium tuberculosis or other Mycobacterium species is a major communicable disease worldwide.
  
  
  OBJECTIVE
  We evaluated the epidemiology of tuberculous peritonitis to determine diagnostic features and factors related to late diagnosis.
  
  
  METHODS
  We retrospectively reviewed 211 tuberculous peritonitis cases diagnosed between January 1999 and December 2009. Clinical features, laboratory data, and diagnostic methods were analysed.
  
  
  RESULTS
  Subjects included 115 males (54.5%) and 96 females (45.5%) with median age 61.0 years (range 43-72) and 29.2 days mean duration from symptoms to diagnosis. Disease histories included end-stage renal disease (20.9%), pulmonary tuberculosis (36.0%) and liver cirrhosis (23.7%). Most common symptoms were abdominal distension (80.1%), abdominal pain (68.7%) and weight loss (45.5%). Most common signs were ascites (62.6%) and fever (55.5%). One-year survival rate was 89.9%; 21 patients died during follow-up. Mortality risk was higher in patients with more concomitant diseases, including liver cirrhosis, AIDS, chronic steroid use, alcoholism, GI bleeding, haemoptysis, period from symptom presentation to treatment, secondary bacterial peritonitis requiring emergent operation.
  
  
  CONCLUSIONS
  Increased duration between symptoms and definitive diagnosis increases mortality risk. Early diagnosis and prompt initiation of anti-tuberculosis therapy improve prognosis. Neutrophil-predominant ascites influences poor prognosis when correlated with secondary bacterial peritonitis.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Hsiu-Fen
authors.initials: HF
authors.lastname: Yeh
authors.forename: Te-Fa
authors.initials: TF
authors.lastname: Chiu
authors.forename: Jih-Chang
authors.initials: JC
authors.lastname: Chen
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
mesh_terms: D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010537:Peritoneum / Q000382:microbiology*; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors