title: Disseminated tuberculosis presenting as tuberculous peritonitis and sepsis tuberculosa gravissima in a patient with cirrhosis of the liver: A diagnosis of challenge.
abstract: We report the case of an 81-year-old man diagnosed with liver cirrhosis complicated by spontaneous bacterial peritonitis and septic shock. Mycobacterium tuberculosis complex was isolated from the ascites, sputum, and blood culture 1 month after the patient died. Clinicians should be aware of the unusual diagnosis of sepsis tuberculosa gravissima presenting with tuberculous peritonitis, which is easily misdiagnosed as spontaneous bacterial peritonitis and Gram-negative bacillus sepsis in patients with cirrhosis. Clinicians should cautiously evaluate the patient's sputum, gastric contents, urine, cerebrospinal fluid, and bone marrow for early diagnosis of disseminated tuberculosis in patients with a high degree of suspicion of this diagnosis.
authors: Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Chun-Yuan
authors: CY
authors: Lee
authors: Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Hung-Chin
authors: HC
authors: Tsai
authors: Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Susan Shin-Jung
authors: SS
authors: Lee
authors: Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: ChengLen
authors: C
authors: Sy
authors: Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: hctsai1011@yahoo.com.tw.
authors: Yao-Shen
authors: YS
authors: Chen
mesh_terms: D000369:Aged, 80 and over; D001201:Ascites / Q000382:microbiology; D001424:Bacterial Infections / Q000382:microbiology* / Q000401:mortality; D001769:Blood / Q000382:microbiology; D003920:Diabetes Mellitus; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000382:microbiology*; D018805:Sepsis / Q000382:microbiology* / Q000401:mortality; D013183:Sputum / Q000382:microbiology
keywords: Liver cirrhosis; Spontaneous bacterial peritonitis; Tuberculous peritonitis