{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:42:53Z","timestamp":1785408173554,"version":"3.56.0"},"reference-count":18,"publisher":"Department of Medicine, Warren Alpert Medical School at Brown University","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Peritoneal tuberculosis (PTB) is a diagnostic challenge due to its nonspecific presentation, low sensitivity of ascitic fluid microbiologic tests, and possible resemblance to peritoneal carcinomatosis. We describe a case of 51-year-old woman with long-term tumor necrosis factor alpha (TNF-\u03b1) inhibitor exposure presented with fever and abdominal distension after returning from the Philippines. Initial tests, including microbiological studies, were inconclusive, despite imaging findings suggestive of carcinomatosis with elevated CA-125. Diagnostic laparoscopy revealed miliary white nodules; however, omental biopsy showed non-necrotizing granulomas without AFB. High clinical suspicion prompted excision of an enlarged axillary lymph node, which demonstrated necrotizing granulomas with rare AFB-positivity and ultimately grew Mycobacterium tuberculosis. The patient experienced rapid symptomatic relief and near-complete radiological resolution within four months of tuberculosis (TB) treatment. PTB should remain on the differential for unexplained ascites or peritoneal nodularity \u2013 particularly in immunosuppressed travelers from endemic regions \u2013 even when early microbiologic tests are negative. Timely invasive sampling and, when warranted, empirical anti-TB therapy is critical. Clinicians must recognize that patients on TNF-\u03b1 inhibitors remain at heightened risk for extrapulmonary TB despite negative baseline screening.<\/jats:p>","DOI":"10.56305\/001c.140744","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:26:54Z","timestamp":1751354814000},"source":"Crossref","is-referenced-by-count":0,"title":["Peritoneal Tuberculosis in a Patient on Tumor Necrosis Factor inhibitors: A Case Report and Review of the Literature"],"prefix":"10.56305","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1578-1482","authenticated-orcid":true,"given":"Seohyeon","family":"Im","sequence":"first","affiliation":[{"name":"Mass General Brigham-Salem Hospital","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gogolashvili","sequence":"additional","affiliation":[{"name":"Mass General Brigham-Salem Hospital","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel H.","family":"Gonzalez-Bocco","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital","department":["Division of Infectious Diseases"]},{"id":[{"id":"https:\/\/ror.org\/02jzgtq86","id-type":"ROR","asserted-by":"publisher"}],"name":"Dana-Farber Cancer Institute","department":["Department of Medical Oncology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derin D.","family":"Allard","sequence":"additional","affiliation":[{"name":"Mass General Brigham-Salem Hospital","department":["Department of Family Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Urma","sequence":"additional","affiliation":[{"name":"Mass General Brigham-Salem Hospital","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Altamimi","sequence":"additional","affiliation":[{"name":"Mass General Brigham-Salem Hospital","department":["Department of Infectious Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"issue":"15","key":"ref1","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1056\/NEJMoa011110","article-title":"Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent","volume":"345","author":"J. 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