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Published on: August 16, 2021
Tuberculosis in children undergoing hemodialysis
Gargah Tahar1, Rim Goucha-Louzir, Lakhoua Mohamed Rachid
1Department of Pediatric Nephrology, Charles Nicolle Hospital, Tunis, Tunisia. kitomora@yahoo.fr
Summary
Tuberculosis (TB) in children undergoing hemodialysis often presents with nonspecific symptoms and extrapulmonary involvement. Early diagnosis and treatment are crucial for favorable outcomes in this vulnerable population.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) poses a significant public health challenge, particularly in immunocompromised individuals.
- Children undergoing hemodialysis are at increased risk for TB, often presenting with atypical extrapulmonary manifestations and diagnostic challenges.
Purpose of the Study:
- To evaluate the incidence of TB in Tunisian children on hemodialysis.
- To describe the clinical features and treatment outcomes of TB in this patient group.
Main Methods:
- Retrospective study of seven TB pediatric patients on hemodialysis (2002-2008).
- Diagnosis confirmed via clinical, radiological, biochemical, microbiological, and histological examinations.
- Assessment of anti-TB chemotherapy regimens and patient outcomes.
Main Results:
- TB incidence was observed in 7 out of 112 children on hemodialysis.
- Common symptoms included weight loss and fever; extrapulmonary sites (pleural, peritoneal, spinal, cervical lymphatic) were frequently involved.
- Diagnosis relied on mycobacterial isolation, histology, or compatible clinical/radiological findings; one patient died, while others showed favorable outcomes.
Conclusions:
- Tuberculosis in pediatric hemodialysis patients exhibits nonspecific clinical presentations and a high rate of extrapulmonary disease.
- Prompt diagnosis, though challenging, is key to successful treatment and improved patient outcomes.
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