Abstract
The aim of this study was to compare the characteristics of tuberculous peritonitis (TP) and spontaneous bacterial peritonitis (SBP) in cirrhotic patients. In a retrospective review of the medical records of a single tertiary hospital between 1988 and 2006, 15 patients met the diagnostic criteria TP and liver cirrhosis. For comparison, we randomly selected 3 cirrhotic patients with SBP caused by Escherichia coli for each cirrhotic patient with TP. Compared to SBP, TP in cirrhotic patients was more frequently associated with extra-peritoneal tuberculosis (TP vs SBP: 53.3% vs 0%), an insidious onset (≥2 weeks; 60% vs 2.2%), and Child–Pugh classification class B at onset (80% vs 8.9%) (p<0.05). Compared to SBP, TP was associated with lower white blood cell count in ascites (TP vs SBP: 2.0±2.2×103/mm3 vs 7.2±7.5×103/mm3), a higher proportion of mononuclear leukocytes (lymphocytes and monocytes) in ascites (88.9±9.5% vs 16.6±15.3%), higher protein concentration in ascites (3.1±1.7 g/dl vs 1.2±0.3 g/dl), and higher adenosine deaminase activity in ascites (62.3±31.8 U/l vs 6.9±3.1 U/l) (p<0.05). TP should be suspected in cirrhotic patients with relevant clinical manifestations and characteristics of ascites.