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Case Reports in Medicine
Volume 2012, Article ID 215293, 3 pages
http://dx.doi.org/10.1155/2012/215293
Case Report

TB Peritonitis Mistaken for Ovarian Carcinomatosis Based on an Elevated CA-125

1College of Human Medicine Michigan State University, East Lansing, MI 48824, USA
2Department of Internal Medicine, Grand Rapids Medical Education Partners, Grand Rapids, MI 49503, USA

Received 4 November 2011; Accepted 13 December 2011

Academic Editor: Jahn M. Nesland

Copyright © 2012 Joseph D. Boss et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. In the United States, tuberculosis (TB) is of relatively low prevalence and most newly diagnosed patients are born outside of the United States. In addition, a large percentage (20.6%) of TB cases initially present with extrapulmonary manifestations (CDC, 2010). Cases of TB peritonitis are a diagnostic challenge in women due to the nonspecific clinical features overlapping with signs of ovarian cancer. (Kosseifi et al., 2009; Rashed et al., 2007; and Xi et al., 2010). We present a 27 year-old woman thought to have ovarian carcinomatosis based on elevated levels of CA-125 who was ultimately diagnosed with TB salpingitis, endometritis, and peritonitis. Methods. This brief report is a retrospective case report. Results. This case outlines the unfortunate consequences of the misdiagnosis of what probably was an antibiotic responsive illness, resulting in an unnecessarily aggressive surgical procedure. The delay in the diagnosis of tuberculous pertitonitis resulted in an unnecessary radical resection of the patient’s reproductive organs. Conclusions. Patients with TB peritonitis present with non-specific signs that may be misdiagnoses as ovarian cancer. In differentiating between ovarian carcinomatosis and peritoneal TB, it is vital to consider country of origin, age, CA-125, ascitic fluid analysis, and the use of intra-operative frozen sections.