Peritoneal tuberculosis, an underestimated diagnosis: a case report
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Tuberculosis is an infectious disease that most often affects the lungs, caused by human-to-human transmission of Mycobacterium tuberculosis . Peritoneal tuberculosis is an extra-pulmonary form of the disease that usually manifests as an ascitic syndrome, with or without fever, in a context of altered general condition, often in endemic areas. The diagnosis of peritoneal tuberculosis is not always easy, as the clinical signs are often insidious and unspecific. We report a case of peritoneal tuberculosis in an 18-year-old female, who had presented for 10 days with a progressive increase in abdominal volume associated with vomiting and diarrhoea.
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The work presented is clear and the arguments well formed. This is a study that would be of interest to the field and community.
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Comments to Author
Minor revision Line 20-21 and Line 50-51 is a repeat. Please rephrase the sentence. Line 22-23 and Line 53- 54: Please rephrase the sentence. Table 1, align the middle justification of words Results and Units Line 136, full stop at end of a sentence I recommend the manuscript for publication after minor revision
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or …
Comments to Author
Minor revision Line 20-21 and Line 50-51 is a repeat. Please rephrase the sentence. Line 22-23 and Line 53- 54: Please rephrase the sentence. Table 1, align the middle justification of words Results and Units Line 136, full stop at end of a sentence I recommend the manuscript for publication after minor revision
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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Comments to Author
The research conducted by Laamara et al., titled "Peritoneal Tuberculosis: An Underestimated Diagnosis," presents a case involving a young 18-year-old female patient who experienced a gradual increase in abdominal volume, along with vomiting and diarrhea over 10 days. Due to the exudative and lymphocytic nature of the ascites fluid, the researchers conducted a molecular biology PCR GeneXpert®MTB/RIF test for Mycobacterium tuberculosis, which yielded a positive result for peritoneal tuberculosis. While the manuscript holds significant interest for both the general audience and the scientific community by emphasizing the importance of diagnostic procedures for Peritoneal Tuberculosis, a notable weakness is the lack of supporting data. I strongly recommend a thorough revision of the manuscript to include …
Comments to Author
The research conducted by Laamara et al., titled "Peritoneal Tuberculosis: An Underestimated Diagnosis," presents a case involving a young 18-year-old female patient who experienced a gradual increase in abdominal volume, along with vomiting and diarrhea over 10 days. Due to the exudative and lymphocytic nature of the ascites fluid, the researchers conducted a molecular biology PCR GeneXpert®MTB/RIF test for Mycobacterium tuberculosis, which yielded a positive result for peritoneal tuberculosis. While the manuscript holds significant interest for both the general audience and the scientific community by emphasizing the importance of diagnostic procedures for Peritoneal Tuberculosis, a notable weakness is the lack of supporting data. I strongly recommend a thorough revision of the manuscript to include relevant and substantial supporting data. Additionally, incorporating proper scientific English and ensuring a cohesive flow in the description would enhance the overall quality of the manuscript. One aspect missing in the current document is the mention of any biomarker for Peritoneal Tuberculosis. I suggest citing plausible biomarkers associated with this condition. Furthermore, it would be beneficial to address whether bacteria in the case could be in a latent or active TB state. Besides the PCR GeneXpert®MTB/RIF test and sputum analysis, I am curious if the authors utilized any other diagnostic methods to correlate the disease. Exploring additional early diagnostic approaches could provide a more comprehensive understanding of the case. Major 1. The title reflects the review. Please replace it with the case report outcome. 2. CT scan data should be mentioned in the case study 3. Test results can be shown in a table with deviation from the reference values Minor 1. These details and the threats given to the patient must be briefly mentioned in the abstract 2. It is currently on the increase in line 59, please modify the sentence 3. "This abdominal tuberculosis is" replaced with "and characterized by" line 69 4. "In Morocco, a total of 29,327 cases, have been notified and put on treatment in 2021, as part of the National Tuberculosis Control Program (PNLAT)" repeat in the abstract, please modify Lines 67-68 5. Lines 70-71 and 73-74 need to be rewritten with the flow connecting the previous and later paragraph 6. Line 118-119- repeat elsewhere, please modify the sentence 7. Discussion:Please start the discussion with your case study and interpretation followed by treatment then continue discussing disease and cure. The discussion has been written in bits and pieces. It does not follow the flow. Please thoroughly edit that. 8. Reference 1 and 4: Please provide an English version for a general audience
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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The reviewers have highlighted major concerns with the work presented. Please ensure that you address their comments.
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Comments to Author
Case report ACMI-D-23-00225 by Laamara et al, entitled Peritoneal Tuberculosis: An underestimated diagnosis The authors in this case report present an 18 year -old female patient who had presented to the emergency department with a progressive increase in abdominal volume associated with vomiting and diarrhoea for 10 days no particular medical history. An abdominal CT scan that was done showed abundant partitioned ascites associated with peritoneal thickening and diffuse mesenteric infiltration, which lead to the diagnosis of Mycobacterium tuberculosis complex by the PCR test GeneXpert® MTB/RIF assay. The patient was introduced to 1st line TB treatment. This case report highlights the successful rapid diagnosis of peritoneal tuberculosis caused by Mtbc using Xpert MTB/RIF assay. Major comments:
Comments to Author
Case report ACMI-D-23-00225 by Laamara et al, entitled Peritoneal Tuberculosis: An underestimated diagnosis The authors in this case report present an 18 year -old female patient who had presented to the emergency department with a progressive increase in abdominal volume associated with vomiting and diarrhoea for 10 days no particular medical history. An abdominal CT scan that was done showed abundant partitioned ascites associated with peritoneal thickening and diffuse mesenteric infiltration, which lead to the diagnosis of Mycobacterium tuberculosis complex by the PCR test GeneXpert® MTB/RIF assay. The patient was introduced to 1st line TB treatment. This case report highlights the successful rapid diagnosis of peritoneal tuberculosis caused by Mtbc using Xpert MTB/RIF assay. Major comments: Some of the information in the abstract is misplaced and should be moved to the introduction section. There is no consistency is writing the Xpert MTB/RIF assay throughout the manuscript, this should be corrected. Ascites is defined as the pathologic accumulation of fluid within the peritoneal cavity, moreover, there are many diseases that can cause ascites, such as cirrhosis. Should the term "ascites fluid" be used instead of ascetic fluid? The global prevalence of tuberculosis is indicated in the introduction, but there is no global and/or national prevalence of peritoneal tuberculosis in this section, and therefore should also be indicated. Also, it might be of benefit to include more information from recent articles in the manuscript. Line 93-what is PNN? Should be written in full. In lines 102-103 - the authors refer to "The aerobic bacterial culture remained sterile", what do the authors mean about this statement? Lines 106-107, this statement needs to be rephrased as it is a bit confusing. Lines 109 -110, the authors indicated that "a sputum test of Mycobacterium tuberculosis was used in the diagnosis of pulmonary tuberculosis using 3 samples, was negative". Which sputum test is this that was used here, it would have been ideal to mention the test. Lines 112-113 - The authors should be consistent is writing Rifampicin, line 157 - the authors introduce Rifampin, this should be corrected. Was the patient treated successfully? How long was the patient treated, as this is not indicated in the manuscript and this affects the discussion and conclusion of the manuscript, authors must include this information. Lines 138-139 - Which direct examination method was used? And which specific medium with better sensitivity are the authors referring to? There were no pictures or scans that were provided with the case report. To enhance this case report, I would suggest that the authors must include a CT scan that was taken and a histopathology slide, if these are available. Conclusion section should include a summative statement and also a recommendation statement to clinicians/scientific/medical community.
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
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