Abstract
A 10-year-old boy on continuous ambulatory peritoneal dialysis had low-grade fever, pain and tenderness of the right shoulder; he had no history of infection or exposure to tuberculosis. The underlying granulomatous infection was diagnosed by histological examination of bone and the polymerase chain reaction with primer sequences specific forMycobacterium tuberculosis. Special stains and cultures were negative. The initiation of antituberculous therapy was followed by a sharp improvement in the fever, malaise and shoulder pain within several weeks. Extrapulmonary tuberculosis is common in patients with chronic renal failure on dialysis and the diagnosis is difficult. The clinician must recognise the high and early mortality rate in order to initiate an aggressive diagnostic approach and early therapy.
References
Cuss FMC, Carmichael DJS, Linington A, Hulme B (1985) Tuberculosis in renal failure: a high incidence in patients born in the third world. Clin Nephrol 25:129–133
Ahijado F, Luno J, Soto I, Gallego E, Junco E, Polo JR, Galan A, Valderrabano F (1991) Tuberculous peritonitis in patients on CAPD. Contrib Nephrol 89:79–86
Sasaki S, Ahiba T, Suenaga M, Tomura S, Yoshiyama N, Nakagawa S, Shoji T, Sasaoka T, Takeuchi J (1979) Ten years survey of dialysis-associated tuberculosis. Nephron 24:141–145
Ong ACM, Scoble JE, Baillod RA, Fernando ON, Sweny P, Moorhead JF (1992) Tuberculous peritonitis complicating peritoneal dialysis: a case for early diagnostic laparotomy. Nephrol Dial Transplant 7:443–446
Mallat SG, Brensilver JM (1989) Tuberculosis peritonitis in a CAPD patient cured without catheter removal: case report, review of the literature and guidelines for treatment and diagnosis. Am J Kidney Dis 12:154–157
Llorach M (1980) Overlooked tuberculosis in chronic haemodialysis patients. Nephrol 25:301
Ghossein RA, Ross DG, Salomon RN, Rabson AR (1992) Rapid detection and species identification of mycobacteria in paraffin-embedded tissues by polymerase chain reaction. Diagn Mol Pathol 1:185–191
Yamaguchi R, Matsuo K, Yamazaki A, Abe C, Nagai S, Terasaka K, Yamada T (1989) Cloning and characterization of the gene immunogenic protein MPB64 ofMycobacterium bovis BCG. Infect Immun 57:283–288
Starke JR (1993) Childhood tuberculosis in the 1990's. Pediatr Ann 22:550–560
Hannania N, Hoffstein V (1993) Tuberculosis presenting with generalized lymphadenopathy, pulmonary infiltrates and bone destruction in a young man. Arch Intern Med 153:1265–1268
Sinnot JT, Cancio MR, Frankle MA, Gustke K, Spiegel PG (1990) Tuberculous osteomyelitis masked by concomitant staphylococcal infection. Arch Intern Med 150:1865–1867
Koçoğlu F (1986) Verem Savaşi. HÜTF Halk Sağhği Ana Bilim Dah Yayini 86:36
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Yalçmkaya, F., Tümer, N., Akar, N. et al. Tuberculous osteomyelitis: an unusual case of tuberculous infection in a child undergoing continuous ambulatory peritoneal dialysis. Pediatr Nephrol 9, 485–486 (1995). https://doi.org/10.1007/BF00866737
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DOI: https://doi.org/10.1007/BF00866737