2020 Volume 40 Issue 5 Pages 697-700
We report a case of tuberculous abdominal wall abscess forming a large cyst in the abdominal cavity. An 85–year–old male patient with a history of pulmonary tuberculosis presented to us complaining of a continuous discharge from the abdominal wall. He had been diagnosed as having peritoneal cancer 8 months before, and a peritoneal infusion port had been implanted. However, tubercle bacilli were identified in the ascitic fluid, and the patient was diagnosed as having tuberculous peritonitis and started on antituberculous therapy. Four months after implantation of the port, the port was removed due to infection. Mycobacterium tuberculosis complex was detected in the purulent discharge and the antituberculous therapy was continued. However, the purulent discharge from the abdomen persisted, and the patient was referred to our hospital. Abdominal CT revealed an area of fluid accumulation bounded by a capsule just beneath the abdominal wall. Daily percutaneous drainage irrigation was performed to treat the abscess. Bacterial testing of the abscess fluid revealed a positive result of the Polymerase Chain Reaction assay for tubercle bacilli and also a positive result for methicillin–sensitive Staphylococcus aureus, therefore, bacterial co–infection of the tuberculous abdominal wall abscess was considered. Antibacterial therapy was added, while the antituberculous therapy was continued. In response to the treatment, the purulent discharge decreased and the abscess diminished in size.
