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Peritonitis refractaria asociada a la diálisis peritoneal causada por Mycobacterium tuberculosis identificada por el
Lichun Wang1, Junjie Xu2, Peihua He3
1Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 53 Jida Jingle Road, Xiangzhou District, Zhuhai, Guangdong Province, 519015, China. wanglichun322@163.com.
BMC nephrology
|February 21, 2026
Resumen
La peritonitis relacionada con la tuberculosis es una complicación rara en pacientes en diálisis peritoneal. La secuenciación metagenómica ayudó al diagnóstico cuando los cultivos fueron negativos, lo que permitió un tratamiento anti-tuberculosis oportuno y una continuación exitosa del tratamiento.
Área de la Ciencia:
- Nefrología Nefrología.
- Enfermedades infecciosas Enfermedades infecciosas.
- La genómica es la genómica.
Sus antecedentes:
- La peritonitis asociada a la diálisis peritoneal (PDAP) es una complicación frecuente de la diálisis peritoneal (DP).
- La peritonitis relacionada con la tuberculosis (TRP) en pacientes con EP es poco común, presentándose con síntomas inespecíficos y a menudo negativos en las pruebas de diagnóstico convencionales.
- El diagnóstico temprano y el manejo de la TRP son cruciales para prevenir el fracaso de la técnica y mejorar los resultados de los pacientes.
Objetivo del estudio:
- Para reportar un caso de peritonitis relacionada con la tuberculosis en un paciente sometido a diálisis peritoneal de mantenimiento.
- Para resaltar los desafíos de diagnóstico asociados con esta rara condición.
- Evaluar la utilidad de la secuenciación metagenómica de próxima generación (mNGS) como herramienta de diagnóstico.
Principales métodos:
- Se presenta un informe de caso de una mujer de 34 años con enfermedad renal en etapa terminal en la EP.
- El paciente exhibió síntomas de fiebre, dolor abdominal y diarrea con cultivos convencionales negativos.
- Se realizó la secuenciación metagenómica de próxima generación del efluente de diálisis peritoneal.
Principales resultados:
- Los cultivos convencionales de bacterias y hongos de efluentes y sangre de PD fueron negativos.
- La secuenciación metagenómica de próxima generación identificó a Mycobacterium tuberculosis en el efluente de PD.
- La terapia antituberculosa condujo a la resolución de los síntomas, lo que permitió la suspensión temporal y la posterior reanudación de la PD.
Conclusiones:
- La peritonitis relacionada con la tuberculosis plantea desafíos diagnósticos significativos en los pacientes con EP.
- La secuenciación metagenómica de próxima generación puede ser una valiosa herramienta complementaria para el diagnóstico de TRP cuando fallan los métodos convencionales.
- Esta técnica molecular puede facilitar el diagnóstico precoz y el manejo apropiado, mejorando los resultados.
Palabras clave:
El Mycobacterium tuberculosis es una bacteria muy común.La peritonitis con cultivo negativo es una peritonitis con cultivo negativo.Secuenciación metagenómica de próxima generación.Peritonitis asociada con la diálisis peritoneal asociada con la diálisis peritonealLa peritonitis relacionada con la tuberculosis es una enfermedad relacionada con la tuberculosis.
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