Case 35-1988

To the Editor: Case 35–1988 (Sept. 1 issue)¹ described a 63-year-old man admitted to the hospital because of fever and diarrhea who ultimately was found to have disseminated tuberculosis with liver and peritoneal involvement. Donowitz's discussion and differential diagnosis were interesting and enlightening. Of particular concern to us, however, was the fact that a diagnostic paracentesis was never performed and the role of diagnostic laparoscopy was not discussed. Diagnostic paracentesis is indicated in any patient with ascites of uncertain cause. It should be considered imperative to rule out peritonitis if, as in the study patient, the patient presents with fever…