Peritoneal tuberculosis in remote area: a case report

Background: Peritoneal tuberculosis (PTB) is a rare form of extrapulmonary TB caused by Mycobacterium tuberculosis. PTB presents with nonspecific symptoms that often overlap with other abdominal conditions, complicating its diagnosis, especially in resource-limited settings. Early and accurate diagnosis is critical due to the disease’s potential severity, yet advanced diagnostic tools are often inaccessible in remote areas. Case Presentation: A 49-year-old Papuan woman presented with a primary complaint of progressive abdominal distension over three years, recently accompanied by a productive cough and mild shortness of breath. Physical examination revealed ascites and wheezing in the upper chest. Laboratory findings indicated anemia and elevated leukocytes, with hypercholesterolemia also noted. Paracentesis showed acid-fast bacilli (AFB) in ascitic fluid, confirming PTB, though GeneXpert testing was negative. The patient received intravenous antibiotics, anti-tubercular therapy, and supportive medications, leading to clinical improvement after one week. Her treatment was continued with close monitoring upon discharge. Conclusion: The discrepancy between AFB and GeneXpert results underscores the importance of utilizing diverse diagnostic tools when advanced methods are unavailable. Comprehensive management, including anti-tubercular therapy and supportive care, is essential for positive outcomes in PTB cases in resource-limited settings.