Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/12620
ชื่อเรื่อง: Tuberculous peritonitis in a cerebral palsy patient: A challenge in diagnosis and management
ผู้แต่ง: Tangsirapat V.
Chakrapan Na Ayudhya V.
Kongon P.
Chakrapan Na Ayudhya K.
Sookpotarom P.
Vejchapipat P.
Keywords: ceftriaxone
metronidazole
terbium
tuberculostatic agent
abdominal distension
abdominal pain
abdominal radiography
abdominal tenderness
Acinetobacter infection
adult
appendix perforation
Article
bacterium culture
case report
cerebral palsy
clinical article
computer assisted tomography
dehydration
diagnostic error
fatigue
fever
hospital acquired pneumonia
human
large intestine disease
leukocyte count
linear energy transfer
male
mental development
mental health
Mycobacterium tuberculosis
neutrophil count
polymerase chain reaction
priority journal
spasticity
tuberculous peritonitis
vomiting
young adult
วันที่เผยแพร่: 2019
บทคัดย่อ: Introduction: Diagnosis of tuberculous peritonitis (TBP) in a normal person, although possible, is often difficult to make because of its non-specific symptoms and signs. However, establishing a diagnosis of TBP in a patient with cerebral palsy (CP) does not seem to be possible due to impaired mental development accompanied by communication problems. Presentation of case: A 19-year-old spastic man diagnosed with CP presented with fever and a nonverbal complaint of abdominal pain. The conditions were hard to evaluate due to his mental status. Abdominal radiography showed dilatation of both small and large bowels, and a subsequent computed tomography (CT) scan did not provide any additional information. With respect to a common suspected cause, a diagnosis of perforated appendicitis was established. However, at the theatre, there was only bowel dilatation with multiple small nodules at the serosa of small and large bowels. Postoperatively, polymerase chain reaction and culture revealed Mycobacterium tuberculosis, thereby leading to a diagnosis of TBP. Discussion: Due to spasticity caused by CP, on examination, the patient presented with board-like rigidity, from which a diagnosis of a surgical condition was established. The misdiagnosis of an acute abdomen situation had let the patient to undergo an unnecessary exploration. To our knowledge, there has not been a report of TBP in a CP patient. Conclusion: The diagnosis of TBP had been complicated by the presence of CP in the reported case. The underlying CP not only preclude the diagnosis of TBP, but also produced symptoms that mimicked a condition requiring surgery. © 2019 The Authors
URI: https://ir.swu.ac.th/jspui/handle/123456789/12620
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064569340&doi=10.1016%2fj.ijscr.2019.04.019&partnerID=40&md5=ab9837385a552598fb04d2f90e6ed1bd
ISSN: 22102612
Appears in Collections:Scopus 1983-2021

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