The incidence and clinical characteristics of mycobacteriosis in patients attending the nephrology department in a hospital in Madrid, Spain, during a 30-month period were analysed retrospectively. Twenty-two new cases of tuberculosis were detected among 525 patients studied. No cases of clinically significant atypical mycobacteriosis were found. The estimated overall annual incidence of tuberculosis in these patients was 259 cases per 100,000 population, which is much higher than the national annual incidence in Spain of 35 per 100,000 population. Most cases were asymptomatic when diagnosed and extrapulmonary involvement was the rule (86% of all patients). In areas with a high prevalence of tuberculosis, renal patients in high-risk groups (renal transplant recipients, haemodialysis and CAPD patients) should be examined periodically to exclude silent infection.

A total of 67 cases of tuberculosis was diagnosed in the first 100 cases of AIDS, diagnosed according to the former CDC criteria, at a hospital in Madrid, Spain. This is the highest known prevalence of tuberculosis in AIDS patients both within and outside Spain. The clinical manifestations of tuberculosis were very variable and atypical. The rate of isolation of Mycobacterium tuberculosis from blood was particularly high: of 25 patients in whom blood cultures were performed, 16 were positive. In a third of the patients with proven mycobacteremia, blood was the first or the only positive specimen. In general, therapy resulted in rapid clinical improvement, but in some cases mycobacteria were isolated from clinical or necroscopy specimens months after what was considered adequate therapy.

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