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Tuberculous Peritonitis in a Peritoneal Dialysis Paediatric Patient: A Case Report
Marwh Aldriwesh1,2, Hessa Albass1, Shog Alzaben1
1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Abstract:
Mycobacterium tuberculosis is known to cause infection primarily in the lungs, which may spread to other parts of the body causing extrapulmonary tuberculosis. Few studies in the literature identify M. tuberculosis as a cause of peritoneal dialysis (PD)-associated peritonitis among paediatric patients who have no history of pulmonary tuberculosis. PD is the most used renal replacement therapy for paediatric patients with end-stage renal disease. However, despite continuous improvements in the PD connecting system, peritonitis remains the Achilles' heel of dialysis procedures and prophylaxis for PD. Here, we report a case of M. tuberculosis peritonitis in a paediatric patient receiving PD and the infection was managed successfully with appropriate anti-tuberculous treatment. This case emphasises the importance of considering tuberculous peritonitis in PD paediatrics patients who have no history of pulmonary tuberculosis and whose PD routine cultures produce negative results.
Insights
Tuberculosis peritonitis can occur in children undergoing peritoneal dialysis (PD) even without lung infection. Early diagnosis and anti-tuberculous treatment are crucial for successful management in these pediatric patients.
Area of Science:
- Nephrology
- Infectious Diseases
- Pediatrics
Background:
- Peritoneal dialysis (PD) is a primary renal replacement therapy for pediatric end-stage renal disease.
- Peritonitis remains a significant complication of PD, despite advancements in dialysis technology.
- Extrapulmonary tuberculosis, particularly tuberculous peritonitis, is less commonly reported in pediatric PD patients without a history of pulmonary tuberculosis.
Observation:
- A case of Mycobacterium tuberculosis peritonitis is presented in a pediatric patient undergoing PD.
- The patient had no prior history of pulmonary tuberculosis.
- Routine PD cultures were negative, complicating initial diagnosis.
Findings:
- Successful management of tuberculous peritonitis was achieved with appropriate anti-tuberculous therapy.
- This case highlights a rare presentation of tuberculosis in a pediatric PD patient.
- Diagnosis was challenging due to the absence of pulmonary symptoms and negative initial cultures.
Implications:
- Clinicians should consider tuberculous peritonitis in pediatric PD patients presenting with unexplained peritonitis, even without pulmonary tuberculosis.
- Diagnostic protocols for PD-associated peritonitis in children may need to be broadened to include tuberculosis, especially with negative routine cultures.
- Early recognition and treatment of tuberculous peritonitis are vital for favorable outcomes in pediatric PD patients.
