title: Cocoon-like fibroadhesive tuberculous peritonitis in a peritoneal dialysis patient.
abstract: Tuberculous peritonitis is a devastating complication of peritoneal dialysis (PD).  Presentations of tuberculous peritonitis range from the common wet ascitic form to the rare fibroadhesive form, which is clinically indistinguishable from encapsulating peritoneal sclerosis.  We describe a 76-year-old man on continuous ambulatory PD for three months developing wet ascitic form of tuberculous peritonitis. Three weeks after institution of antituberculous therapy and removal of PD catheter, his abdominal pain recurred and an encapsulating peritoneal sclerosis-like intestinal obstruction was noted.  A rare fibroadhesive form of tuberculous peritonitis associated with the paradoxical response to antituberculous therapy was considered by excluding noncompliance, drug resistance and adverse effects, and other concomitant infections.  After surgical enterolysis and continuation of antituberculous treatment, he recovered uneventfully.  Our case might be the first report regarding paradoxical deterioration to antituberculous treatment in dialysis patients.
authors.affiliation: Department of Medicine, Taitung Veterans Hospital, Taitung, Taiwan, Republic of China.
authors.forename: Wei-Cheng
authors.initials: WC
authors.lastname: Tseng
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D022001:Focal Adhesions / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology*; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D014395:Peritonitis, Tuberculous / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D000995:Antitubercular Agents