According to World Health Organization (WHO), tuberculosis (TB) is a worldwide pandemic. Up to 5% of patients with TB may have abdominal disease and 25-60% may have peritoneal involvement. Diagnosis of TB peritonitis is still challenging, and symptoms are usually insidious. The sensitivity of acid fast bacilli (AFB) is very low, ranging from 0-6%. Conventional mycobacterial culture takes up to 8 weeks to achieve results. Laparoscopic or laparotomy biopsy is uncomfortable for patient. The

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... ence of these problems is missing and delays in diagnosing TB peritonitis. In the end, it can results in significant morbidity and mortality. This case described a 20 year old female patient with TB peritonitis that suffered from septic shock caused by extended-spectrum beta lactamases (ESBL) producing Pseudomonas aeruginosa. In this case, TB peritonitis was diagnosed based on clinical features, high levels of adenosine deaminase (ADA) and a positive rapid DNA test with Xpert MTB/RIF. Keywords: tuberculosis peritonitis, extended-spectrum beta lactamases producing bacilli, adenosine deaminase, XpertMTB/RIF assay