Peritoneal tuberculosis (PT) is very uncommon and presents a diagnostic challenge, especially in women. Patients often present with non-specific symptoms mimicking advanced stage ovarian cancer. In this case a 20-year-old woman without known exposure to tuberculosis presented with abdominal discomfort, ascites, and markedly increased cancer antigen 125 level. Ovarian cancer was suspected. A positive QuantiFERON test prompted further tests. Pulmonary symptoms were negligible, and sputum microscopy and PCR were negative. Culture was positive after eight weeks. Diagnostic laparoscopy confirmed the diagnosis of PT.
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