A 40-year-old male patient with a history of untreated HCV and HIV cirrhosis.
The patient was seen in the emergency department with a 1-month history of increased abdominal perimeter, jaundice, exertional dyspnea, abdominal pain and fever.
Physical examination revealed non-tension ascites, non-painful hepatomegaly, collateral circulation, telangiectasia, and lower limb edema.
Laboratory tests showed elevated tumor markers: CA 125 519 (n, 0-35), CA 19.9 278 (n, 0-37).
Abdominal ultrasound showed moderate ascites with nodular thickening of the parietal peritoneum fascia.
Given the echography findings, an abdominal CT scan is performed on the visualized adenomas of nodular dementia with fascia suggestive of caseifying necrosis, global hepatomegaly, abundant ascites with thickened properitoneal areas
An ultrasound-guided peritoneal biopsy was performed, which resulted in granulomatous peritonitis with focal caseous necrosis, consistent with TBC.
Ascitic fluid samples were taken for culture, resulting in growth of Mycobacterium tuberculosis.
