A Case Report of Tuberculous Peritonitis with Negative GeneXpert and Positive Metagenomic Sequencing Results

Abstract: A 65-year-old male patient undergoing peritoneal dialysis was diagnosed with Mycobacterium tuberculosis -related peritonitis. Initial diagnostic tests, including acid-fast smear of ascites, GeneXpert test, and Mycobacterium tuberculosis culture, yielded negative results. However, metagenomic capture sequencing (metaCAP) and metagenomic next-generation sequencing (mNGS) identified the presence of Mycobacterium tuberculosis . The patient was subsequently treated with standard anti-tuberculosis therapy, leading to clinical improvement. This case highlights the utility of advanced molecular diagnostics in identifying atypical pathogens in peritoneal dialysis-related infections. Keywords: tuberculous peritonitis, Mycobacterium tuberculosis , next-generation sequencing, GeneXpert