Woman 40 yo with one week fever, abdomen pain and distention..
Clinical examination ruled out surgical needs , chest X-ray is normal.
Ultrasound of abdomen = liver, biliary system, kidney are normal, huge amount of ascites volume with cloudy fluid (us1 , us2, us3 pelvis us4 ovary).
CT scan of abdomen = No tumor detection [ ct1,frontal view, ct2, ct3 cross section].
Blood tests = WBC 15k with 13,3 k neutro, CRP= 25.9, amylase, CEA , CA 125 are normal level. But Widal test is positive th;1/320
Ascites punction= yellow clear, analysis = ADA= 19.5 ng/mL, CA125 :396 UI/mL, CEA: 0,8UI, albumine =3.9 mg/mL
After 2 weeks treated with antibiotics; response is good, no fever but ascites is distention after aspiration many times.
Summary= Fever with typhoid but ascites still persistent after one month.
What we can do for this case?