What the study found
The case showed that tuberculous peritonitis, a tuberculous infection of the peritoneum, can imitate suspected encapsulating peritoneal sclerosis in a long-term peritoneal dialysis patient. In this patient, the diagnosis was revised only after metagenomic next-generation sequencing identified Mycobacterium tuberculosis complex.
Why the authors say this matters
The authors conclude that this kind of overlap can delay diagnosis in peritoneal dialysis patients. They say that high clinical suspicion and advanced molecular diagnostics such as metagenomic next-generation sequencing are crucial for accurate diagnosis, and that catheter removal with anti-tuberculous therapy is the cornerstone of management in such cases.
What the researchers tested
This is a case report of a 59-year-old man who had been on peritoneal dialysis for 14 years and presented with recurrent abdominal pain, fever, and cloudy dialysis fluid. The team used contrast-enhanced computed tomography, peritoneal fluid metagenomic next-generation sequencing, laparoscopic catheter removal, transfer to hemodialysis, and a renal-adjusted anti-tuberculous regimen.
What worked and what didn't
Initial imaging showed diffuse peritoneal thickening, omental caking, and localized ascites, which raised strong suspicion for encapsulating peritoneal sclerosis. The condition relapsed despite broad-spectrum antibiotic therapy, but the diagnosis changed after metagenomic next-generation sequencing found Mycobacterium tuberculosis complex, and the patient then had gradual clinical and biochemical improvement after catheter removal and anti-tuberculous treatment.
What to keep in mind
This summary describes a single case, so it does not establish how often this happens or how the approach performs in other patients. The abstract does not describe comparative testing, and the report does not provide a broader estimate of diagnostic accuracy for imaging or metagenomic next-generation sequencing.
Key points
- Tuberculous peritonitis can mimic encapsulating peritoneal sclerosis in long-term peritoneal dialysis patients.
- In this case, contrast-enhanced CT suggested encapsulating peritoneal sclerosis before the infection was identified.
- Metagenomic next-generation sequencing of peritoneal fluid identified Mycobacterium tuberculosis complex.
- Broad-spectrum antibiotics did not resolve the patient's relapse.
- Catheter removal, hemodialysis, and anti-tuberculous therapy were followed by gradual improvement.
Disclosure
- Research title:
- Tuberculous peritonitis mimicked encapsulating peritoneal sclerosis in a dialysis patient
- Authors:
- Tianjiao Cui, Meng-Lin Huang
- Institutions:
- Sun Yat-sen University, Sun Yat-sen University, The Seventh Affiliated Hospital of Sun Yat-sen University, The Seventh Affiliated Hospital of Sun Yat-sen University
- Publication date:
- 2026-04-02
- OpenAlex record:
- View
- Image credit:
- Francis Fredrick, Gudila Valentine, Wikimedia Commons, CC BY 2.5
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