Peritoneal
tuberculosis (TB) is a rare extrapulmonary manifestation of TB with non-specific clinical characteristics which can produce test results mimicking
malignancy and granulomatous
peritonitis. This case describes a Filipino 59-year-old, nulliparous woman who was admitted with
abdominal pain,
ascites, and an elevated CA-125 level. Radiographically, peritoneal nodules were visualized and initial suspicion was high for
malignancy. Following a bilateral
salpingo-oophorectomy and peritoneal biopsy, histology was negative for
malignancy but revealed non-caseating
granulomas. She was discharged then readmitted with progressive
abdominal pain, and a repeat laparoscopic biopsy yielded specimens with growth of
acid-fast bacilli (AFB). A delay in diagnosis and treatment of
tuberculous peritonitis increases mortality rates, making early diagnosis with laparoscopic biopsy of paramount importance in prompt diagnosis and initiation of
therapy. This patient was initiated on standard anti-TB
therapy and experienced no complications.