Tuberculous peritonitis

 Q: 44 year old male with previous histories of AIDS, cirrhosis, diabetes, underlying Kaposi sarcoma, and renal failure (on continuous ambulatory peritoneal dialysis - CAPD) is admitted in ICU with severe abdominal pain. Subsequent workup diagnosed him with tuberculous peritonitis. Which of his past medical history is the highest risk factor for tuberculous peritonitis?

A) cirrhosis 
B) peritoneal dialysis
C) diabetes mellitus
D) underlying malignancy
E) AIDS

Answer: A

One of the studies has shown the following factors in descending order as risk factors for tuberculous peritonitis. It may be hard to believe that AIDS is the lowest risk factor!

• cirrhosis,
• peritoneal dialysis
• diabetes mellitus
• underlying malignancy
• systemic corticosteroids, and 
• AIDS

#infectious-diseases

Reference:

Chow KM, Chow VC, Hung LC, et al. Tuberculous peritonitis-associated mortality is high among patients waiting for the results of mycobacterial cultures of ascitic fluid samples. Clin Infect Dis 2002; 35:409.