Tijdschrift voor geneeskunde vol:64 issue:19 pages:995-997
A 35-year-old Nepalese man with fever, dry cough and abdominal complaints
The case of a 35-year-old Nepalese man with fever, malaise, dry cough and abdominal complaints is presented. Clinical examination revealed abdominal distention, painful palpation of the right fossa iliaca, and a supraclavicular adenopathy. Laboratory analysis disclosed increased inflammatory parameters. Abdominal ultrasonography showed the presence of ascites, which had a lymphocytic predominance. CT scan revealed intra-abdominal lymphadenopathies. During his hospital stay the patient developed lymphocytic pleuritis.
Because of the clinical, radiological and laboratory findings, the tentative diagnosis of tuberculosis was put forward. The presence of a lymphocytic-rich ascites fluid as well as the Nepalese origin of the patient constituted the main clinical indications to suspect tuberculosis. After several weeks, positive sputum and faeces cultures confirmed the diagnosis of tuberculosis with pleuropulmonary, glandular, peritoneal and intestinal involvement.