Pulmonary and peritoneal tuberculosis in a CAPD patient

Area of Science:

• Nephrology
• Infectious Diseases
• Pulmonology

Background:

• Patients with chronic renal failure exhibit diminished cellular immunity, increasing tuberculosis susceptibility.
• Extrapulmonary tuberculosis is prevalent in over half of these patients.
• Tuberculous peritonitis poses a significant challenge for individuals on continuous ambulatory peritoneal dialysis (CAPD).

Observation:

• A 39-year-old male on CAPD presented with culture-negative peritonitis, unresponsive to standard antimicrobial treatment.
• Symptoms included persistent fever, weight loss, and night sweats.
• After one month, both sputum and peritoneal fluid cultures confirmed Mycobacterium infection.

Findings:

• The patient was initiated on quadruple tuberculosis therapy.
• Prompt clinical improvement was observed following the initiation of antitubercular treatment.
• The patient successfully continued CAPD while undergoing treatment.

Implications:

• Culture-negative peritonitis in CAPD patients unresponsive to conventional antibiotics warrants investigation for tuberculous peritonitis.
• Simultaneous pulmonary and peritoneal tuberculosis, though rare, should be considered in the differential diagnosis.
• Thorough investigation for extraperitoneal tuberculosis, particularly pulmonary involvement, is crucial in such cases.