A paracentesis was performed and revealed the following: RBC count, 50 cells/μL; WBC count, 382 cells/μL (79% lymphocytes, 9% neutrophils, and 12% macrophages); glucose, 50 mg/dL; total protein, 4.7 g/dL; albumin, 1.4 g/dL; and lactate dehydrogenase, 608 U/L. The results for cytology, Gram stain, and acid-fast bacilli smears were negative. The serum-ascites albumin gradient was < 1.1 g/dL, indicating that the ascites were not due to portal hypertension. An ascitic fluid total protein concentration of > 2.5 g/dL, an ascitic lactate dehydrogenase/serum lactate dehydrogenase ratio of > 1, and a low ascitic glucose concentration indicated an exudative process, which implies malignancy, infection, or bowel perforation. The imaging studies and cytology results made the diagnosis of malignancy or perforation unlikely. While the leukocyte count was elevated, it was lower than expected for spontaneous bacterial peritonitis or gut perforation. The lymphocyte predominance also made bacterial peritonitis less likely. Given these results, the protracted duration of symptoms, her country of origin, and the history of tuberculin skin test reactivity, tuberculous peritonitis remained a strong possibility.