Tuberculous peritonitis in peritoneal dialysis: report of three cases

Abstract

Tuberculous peritonitis is a rare but dreaded complication in peritoneal dialysis. We report three cases of tuberculous peritonitis diagnosed in our PD center at over a period of 15 years. They are a woman and two men aged 50, 45 and 64 respectively. The diagnosis of tuberculous peritonitis was suspected in front of a many of clinical (AEG, abdominal pain, cloudy liquid), biological (inflammatory syndrome, the dialysate liquid with lymphocyte predominance and negative culture) and or radiological (abdominal lymphadenopathy) arguments. It was confirmed by the demonstration of Mycobacterium Tuberculosis in the dialysate by GeneXpert or by culture on LOWENSTEIN Jensen medium in 2 cases, and the characteristic appearance on anatomopathological examination in only 1 case. The evolution under antituberculous treatment was favorable, with recourse to the ablation of The diagnosis of tuberculous peritonitis in peritoneal dialysis is difficult and often late because the clinical signs is non-specific. It should be considered in the presence of any culture-negative peritonitis that is refractory to empirical treatment. Bacteriological or histological confirmation should not delay the start of anti-tuberculosis treatment because early diagnosis and rapid initiation of treatment are the keys to recovery and the only guarantee of a good prognosis.