Aim:

To describe the clinical manifestation and the diagnostic process of a patient with peritoneal tuberculosis as a clinical challenge in a tertiary referral center in a Latin American country.

Case description:

A 61-year-old male patient from the urban area of Cali consulted for edema in the lower limbs, ascites, hyporexia, weight loss, cachexia, thrombocytopenia, elevated transaminases, imaging of splenomegaly and pulmonary, hepatic, and peritoneum nodules. Initially, neoplasia was suspected, but the adenosine deaminase report and histopathology were consistent with the diagnosis of peritoneal tuberculosis.

Conclusion:

Peritoneal tuberculosis represents the sixth cause of extrapulmonary tuberculosis, after lymphatic, pleural, osteoarticular, genitourinary, and meningeal manifestations. Despite having surveillance systems, peritoneal tuberculosis is still considered the most challenging infectious disease to reach a definitive diagnosis. We present a case of disseminated tuberculosis in which invasion of the peritoneum was verified, for which tetraconjugate treatment was started; however, the patient showed an adverse hepatic reaction and died due to multisystem involvement of a pulmonary infectious complication.

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