- 期刊
- OpenAccess
Tuberculosis Peritonitis in Patients on Peritoneal Dialysis: Experience in a Medical Center
並列摘要
BACKGROUND. Owing to their compromised local immune system, patients with end-stage renal disease (ESRD), especially those undergoing peritoneal dialysis (PD), are prone to developing tuberculosis peritonitis (TBP). TBP is an uncommon complication, but the mortality rate is high in PD patients.METHODS. We retrospectively reviewed all the cases of TBP occurring in patients receiving PD at our institution over the past 19 years. Seven cases were identified to have TBP during the study period. We presented the clinical and diagnostic features of these patients.RESULTS. The calculated crude rate of TBP patients was 1.0%. The time between onset of symptoms and diagnosis of TBP was around two weeks. All patients presented with fever and abdominal pain. Three patients had co-existing extraperitoneal TB. Six patients had positive results of TB culture. The new TB polymerase chain reaction (PCR) method was applied to four patients who were diagnosed early by a positive peritoneal fluid TB PCR on an average of 6.5 days. All TBP patients received anti-tuberculosis therapy. Two patients suffered from side effects of rifampin, such as jaundice and gastrointestinal upset. Only one patient died from septic shock. Four patients were switched to hemodialysis. No recurrence of TBP was observed during a mean follow-up of 32.6 months.CONCLUSION. Our experience suggests that an effective molecular diagnostic tool (TB PCR) offers better outcomes for patients with TBP, including early diagnoses, prompt therapy, and decreased mortality.
延伸閱讀
- 王沐昕（2017）。A Case-Control Study on Clinical Behavior and Peritonitis in Peritoneal Dialysis Patients〔碩士論文，長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-3005201722224800
- Huang, H. W., Chen, C. H., Cheng, C. H., Wu, M. J., Yu, T. M., Chuang, Y. W., Huang, S. T., & Shu, K. H. (2011). Tuberculosis Infection in Patients on Peritoneal Dialysis: Experience in a Medical Center. Acta Nephrologica, 25(1), 12-16. https://www.airitilibrary.com/Article/Detail?DocID=10131671-201103-201104070029-201104070029-12-16
- Tsai, Y. C., Tsai, T. C., Tsai, J. D., Huang, F. Y., Lin, C. C., & Sheu, J. C. (2006). Clinical Analysis of Chronic Peritoneal Dialysis Related Peritonitis in Children. Acta Paediatrica Taiwanica, 47(2), 72-76. https://doi.org/10.7097/APT.200604.0072
- Sun, C. Y., Lin, H. C., Chen, Y. C., Tsai, C. R., & Wu, M. S. (2006). Painless Tuberculous Peritonitis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis. Acta Nephrologica, 20(3), 207-210. https://www.airitilibrary.com/Article/Detail?DocID=10131671-200607-20-3-207-210-a
- 吳麗惠、林淑卿、吳麗敏、王佳慧（2022）。Using Multiple Strategies to Reduce the Incidence of Peritonitis on Peritoneal Dialysis。臺灣腎臟護理學會雜誌，21(1)，13-29。https://doi.org/10.53106/123412342022112101002