Tuberculosis peritonitis in Negara Brunei Darussalam

Introduction: Tuberculosis peritonitis (TBP) is uncommon and symptoms can be non-specific. Local data are lacking and our aim is to review our local experience with TBP. Materials and Methods: Between the period of 1996 to 2004, there were 10 [male: 6; mean age, 48 +/- 18.5 years (range, 26 to 73)] cases of histologically documented TBP. Comparisons were made with pulmonary tuberculosis (PTB) patients. Results: The overall prevalence ranged from 0% to 1.01% of all TB infections. The median duration of symptoms before diagnosis was 2 months (range, 3 days to 24 months). Five patients (50%) had comorbid conditions and 3 patients (30%) had a history of positive contact. Presenting symptoms were abdominal distension (70%), abdominal pain (60%), fever (60%), anorexia (60%) and weight loss (40%). Two patients had pulmonary symptoms: cough/dyspnoea (n = 1) and cough (n = 1). Chest x-ray changes consistent with PTB were seen in 30%. TBP was diagnosed by laparoscopy (n = 6), laparotomy (n = 3) and blind peritoneal biopsy (n = 1). Adverse effects of TB drugs occurred in 80%, consisting of hepatitis (n = 4), nausea/vomiting (n = 2), rash (n = 1) and encephalopathy (n = 1). Haemoglobin (P = 0.026) and serum albumin levels (P = 0.002) were significantly lower in TBP patients. There was a significantly greater number of adverse effects (P < 0.001). There were no significant differences between TBP and PTB with regard to age, non-specific symptoms (weight loss, anorexia and fever) and erythrocyte sedimentation rate. All were treated with standard regimes and there were no mortalities. Conclusions: TBP is uncommon in our population. TBP patients had significantly lower haemoglobin and serum albumin levels. They also experienced more adverse events during treatment. There were no differences in non-specific symptoms between TBP and PTB.