An unexpected presentation of tuberculosis-related abdominal sepsis: A case report and a short review of literature

The current case report is about tuberculosis septic shock in a 45-years-old man without history of immunosuppression. The patient came to Emergency Department because of an acute abdomen with radiographic signs of perforation. An emergent laparotomy was performed and it revealed a viscero-adhesive syndrome with caseous nodules disseminated in the peritoneal cavity. Microbiological exams confirmed the tubercular etiology and the patient was treated through target anti-tuberculous therapy and organ support, given the development of a septic shock. During the surgery, any perforation was not found, thus a laparostomy was done in first moment, until clinical stabilization. The most common extra-pulmonary tuberculosis is the abdominal one whose diagnosis is complicated due to the lack of specific symptoms and imaging exams. A high grade of suspicion allowed a quick diagnosis and an effective treatment, that includes the target antimicrobic therapy and, in case of acute abdomen, urgent surgery.