Tuberculous lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis

Abstract

The aim of this study was to review the clinical features of tuberculous (TB) lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Nine cases of TB lymphadenitis were diagnosed among 910 patients over a period of 10 years. There were five men and four women with a mean age of 51 +/- 15.5 years. The TB lymphadenitis involved the cervical lymph nodes in six patients, supraclavicular lymph nodes in two patients and mediastinal lymph nodes in one patient. Six patients presented with clinically enlarged lymph nodes of whom four also had fever. Three other patients were incidentally found to have enlarged lymph nodes on routine chest X-ray or ultrasound examination of the neck. Diagnosis of TB lymphadenitis was made by demonstrating caseating granulomata with or without positive acid-fast bacilli on excisional lymph node biopsy. All patients were cured with standard anti-tuberculosis drugs for 12 months. No recurrence of the TB lymphadenitis was observed after a mean follow-up of 59 +/- 30 months. We conclude that TB lymphadenitis is not uncommon among patients on CAPD. A high index of suspicion is needed for early diagnosis of this condition. Prompt initiation of anti-tuberculosis treatment is associated with good prognosis.

Tuberculosis of the breast in a patient undergoing hemodialysis

“…The diagnosis of tuberculosis in this population is frequently difficult and delayed because of the high frequency of extrapulmonary involvement and nonspecific symptoms [2][3][4][5][6]. Currently, it is recommended that all patients with end-stage kidney disease should be screened for latent tuberculosis infection with PPD (tuberculin) skin testing [7].…”

Our war against bacteria in peritoneal dialysis, the last 40 years!

“…Almost any bacterium, yeast or filamentous fungi can invade the peritoneal cavity and under the conditions of peritoneal dialysis, even some non-pathogenic agents may become pathogenic [1][2][3][4]. Among all these bacteria, it is infections by Staphylococcus aureus, Pseudomonas species and fungi that do the greatest damage to the patient on peritoneal dialysis.…”

Statin therapy in peritoneal dialysis patients: effects beyond lipid lowering

“…Another advantage of PD over HD is the slower decline of residual kidney function in PD patients [11,12]. A possible drawback associated with PD is an increased risk of catheter-related infections and peritonitis [13][14][15][16][17]. On the other hand, HD patients have a higher incidence of bacteraemias and sepsis from the intravascular lines [18][19][20].…”

“…On the other hand, HD patients have a higher incidence of bacteraemias and sepsis from the intravascular lines [18][19][20]. As a result, overall infection rates do not differ significantly between the two modalities [13][14][15][16][17][18][19][20].…”