Publication:
Tuberculous peritonitis in a cerebral palsy patient: A challenge in diagnosis and management

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Issued Date

2019

Resource Type

Article

File Type

application/pdf

ISSN

22102612

DOI

10.1016/j.ijscr.2019.04.019

Other identifier(s)

2-s2.0-85064569340

Rights Holder(s)

มหาวิทยาลัยศรีนครินทรวิโรฒ

Bibliographic Citation

International Journal of Surgery Case Reports. Vol 58, (2019), p.88-91

Suggested Citation

Tangsirapat V., Chakrapan Na Ayudhya V., Kongon P., Chakrapan Na Ayudhya K., Sookpotarom P., Vejchapipat P. Tuberculous peritonitis in a cerebral palsy patient: A challenge in diagnosis and management. International Journal of Surgery Case Reports. Vol 58, (2019), p.88-91. doi:10.1016/j.ijscr.2019.04.019 Retrieved from: https://hdl.handle.net/20.500.14740/5649

Title

Tuberculous peritonitis in a cerebral palsy patient: A challenge in diagnosis and management

Author(s)

Tangsirapat V.
 Chakrapan Na Ayudhya V.
 Kongon P.
 Chakrapan Na Ayudhya K.
 Sookpotarom P.
 Vejchapipat P.

Abstract

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

Subject(s)

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

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URI

https://hdl.handle.net/20.500.14740/5649

Collections

Scopus: Year 1983-2021

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