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Tuberculosis Infection in Patients on Peritoneal Dialysis: Experience in a Medical Center
並列摘要
BACKGROUND. Tuberculosis (TB) is a serious infection. The incidence of TB in dialysis patients is higher than that in the general population. This study is a retrospective review of the pattern of TB infection in patients on peritoneal dialysis (PD).METHODS. We retrieved the records of 379 patients on PD in Taichung Veterans General Hospital from January 1999 to December 2008. Diagnosis of TB was made by positive acid-fast stain, positive culture or typical pathology on a tissue biopsy specimen. Anti-TB treatment comprised three-and four-drug combination regimens of isoniazid, rifampicin, pyrazinamide and ethambutol for 9-12 months.RESULTS. Twelve cases (3 men and 9 women) with TB infection were found in 379 patients (3.2%) on PD with a mean age of 49.9±17.1 (range: 23.0-81.8) years. Mean interval between initiation of PD to diagnosis of TB was 8±10.3 (range: 1-34) months. There were 4 with pulmonary TB (33.3%), 2 with TB peritonitis (16.7%), 2 with TB lymphadenitis (16.7%), 2 with genitourinary TB (16.7%) and 2 with disseminated TB (16.7%). Patients with pulmonary TB often presented with fever of unknown origin (FUO), cough and pulmonary infiltration on chest radiograph. The main symptoms in extrapulmonary TB were FUO and lymphadenopathy. Unexplained hypercalcemia was found in six patients (50.0%, 2 with pulmonary TB, 4 with extrapulmonary TB). The mean period from onset of symptoms to diagnosis of TB was 39±18.4 (range: 10-74) days. Four of our patients died due to medical problems unrelated to TB. The adverse effects of anti-TB treatment were hepatotoxicity in 2 cases and optic neuritis in 1 case.CONCLUSION. In this retrospective study, we demonstrated higher frequency of TB and extraordinary higher frequency of extrapulmonary TB in PD patients than in the general population. If the patients on PD present with FUO or unexplained hypercalcemia, we should take TB infection into our differential diagnosis.
延伸閱讀
- Chiu, C. H., Lee, C. H., Chen, T. C., Chen, J. B., Lee, C. T., Tsai, Y. C., Hsu, K. T., Cheng, B. C., Chien, Y. S., Su, Y. J., Liao, S. C., & Chuang, F. R. (2011). Tuberculosis Peritonitis in Patients on Peritoneal Dialysis: Experience in a Medical Center. Acta Nephrologica, 25(1), 17-21. https://www.airitilibrary.com/Article/Detail?DocID=10131671-201103-201104070029-201104070029-17-21
- 周麗華（2013）。Non-infective Complications of Peritoneal Dialysis。臺灣腎臟護理學會雜誌，12(2)，10-19。https://www.airitilibrary.com/Article/Detail?DocID=17267404-201306-201308090020-201308090020-10-19
- Finkelstein, F. O. (2016). The Use of Peritoneal Dialysis to Treat Patients with Acute Kidney Injury. Acta Nephrologica, 30(1), 9-11. https://doi.org/10.6221/AN.2015031
- 彭碧慧、徐明儀、吳秀芳（2012）。Reduction of Occurrence of Peritonitis for a Patient with Peritoneal Dialysis。領導護理，13(3)，94-105。https://doi.org/10.29494/LN.201209.0010
- 翁淑滿（2013）。Infectious Complications of Peritoneal Dialysis。臺灣腎臟護理學會雜誌，12(2)，1-9。https://www.airitilibrary.com/Article/Detail?DocID=17267404-201306-201308090020-201308090020-1-9