Case Report YoungMalePresentingwithanAcuteDiarrhealIllnesswith UnexplainedTransudativeAscites:AnAtypicalPresentationof AppendicularTuberculosis ChamaraDalugama , 1 AchilaJayasinghe, 2 ShamaliAbeygunawardena, 1 ManojiPathirage, 1 ThilakJayalath, 1 UdayaRalapanawa, 1 S.S.Jayasundara, 2 andSulochanaWijetunga 3 1 Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka 2 Teaching Hospital, Peradeniya, Sri Lanka 3 Department of Pathology, University of Peradeniya, Peradeniya, Sri Lanka Correspondence should be addressed to Chamara Dalugama; chamaradalugama@yahoo.com Received 7 May 2020; Revised 28 June 2020; Accepted 2 July 2020; Published 16 July 2020 Academic Editor: Larry M. Bush Copyright©2020ChamaraDalugamaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Appendicular tuberculosis is a rare form of extrapulmonary tuberculosis involving the gastrointestinal tract. Diagnosis of appendicular tuberculosis is difficult due to its atypical presentation. Histological confirmation remains the gold standard in diagnosis. Case Presentation. We report a 37-year-old Sri Lankan male presenting with a diarrheal illness with high feverfor8daysinthebackgroundofconstitutionalsymptomsfor1-monthduration.Hewaspaleandhadmoderateamountof free fluid in the abdomen. Inflammatory markers were elevated, and CT abdomen revealed a thickened elongated appendix. Diagnosticparacentesisrevealedalymphocytictransudativeascites.Amacroscopicallyminimallyinflammedappendixremoved atlaparotomyandhistologyconfirmedpresenceoftuberculousgranulomatawithcaseation.Hemadeanuneventfulrecoveryby the anti-tuberculous therapy. Conclusion.Highdegreeofsuspicionisneededindiagnosisofappendiculartuberculosisduetoits nonspecific presentation, and we emphasize the need of histological assessment of the appendix resected for the case of clinical appendicitis, as it may prompt the diagnosis of a rare but treatable case of tuberculosis. 1.Introduction Extrapulmonary tuberculosis still remains a greater diag- nostic challenge to the treating physicians despite ad- vancementismedicaldiagnostics.Intestinaltuberculosisisa form of extrapulmonary tuberculosis with very nonspecific presentation leading to delayed diagnosis. Tuberculosis in- volvingtheappendixcanoccurinassociationwithadjacent ileocecalregionbutveryrarelyinisolation.Anunexplained lymphocytic exudative ascites would prompt a physician to considertuberculosis,butatransudativeascitesmightmake it less likely. We report a rare case of isolated appendicular involvement of tuberculosis in a young male with tran- sudative ascites. 2.CasePresentation A 37-year-old previously healthy Sri Lankan male phar- macist presented to a tertiary care hospital with 8-day historyofintermittenthighspikingfevers.Hehasdeveloped frequentsmallamountsofwateryloosestoolsforthesimilar durationbutdeniedbloodandmucusinstoolsorassociated abdominal pain or tenesmus. He did not have cough, he- moptysis, dysuria, or headache in systemic inquiry. He described feeling unwell for a last one-month period with significantlossofappetiteandweightlossof6kgoverthe1- month period. He did not have any chronic medical illness suchasdiabetesmellitus,hypertension,ordyslipidaemia.He deniedapasthistoryoracontacthistoryoftuberculosisofa Hindawi Case Reports in Infectious Diseases Volume 2020, Article ID 8835081, 5 pages https://doi.org/10.1155/2020/8835081