Abstract
我們報告一個發生在長期腹膜透析病人的結核性腹膜炎病例。此病人的特殊臨床表現為以中性球為主的腹膜透析液及無腹痛。這個63歲女性病患接受腹膜透析已達兩年。她最初住院的原因是長達兩個星期的發燒、寒顫、食慾不振、及腹脹。腹膜透析鏡發現以中性球為主的白血球增多現象。抹片檢查發現有耐酸性桿菌。且進一步在培養中發現了結核桿菌。後來因為持續的血色透析液及透析能力不足，我們決定拔除病人的腹膜透析管，並改為血液透析。這個病例顯示了結核性腹膜炎不一定要有腹痛，或透析液中淋巴球增多現象。
We report a case of tuberculous peritonitis in a chronic peritoneal dialysis patient with unusual initial presentations of painless and neutrophil predominant dialysate. The patient was a 63-year-old female under chronic perironeal dialysis for 2 years. She was admitted to our hospital because of intermittent fever with chills, anorexia and periumbilical abdominal fullness for two weeks. Routine dialysate examination revealed increased leukocyte count in dialysate with neutrophil predominant. MRI and laparoscope c examination found peritoneal cysts. Direct smear of the peritoneal effluent revealed acid-fast bacilli. Peritoneal fluid culture revealed mycobacteria tuberculosis. Due to persistent peritonitis and ultrafiltration inadequacy, the Tenckhoff catheter was removed and renal replacement therapy was shifted to chronic hemodialysis. We presented painless neutrophil-predominant mnycobacteria peritonitis in a patient under chronic peritoneal dialysis. The rare presentations of the complications suggested that abdominal pain could be absent and neutrophil might be predominant in mycobacteria peritonitis in a patient under chronic peritoneal dialysis.
We report a case of tuberculous peritonitis in a chronic peritoneal dialysis patient with unusual initial presentations of painless and neutrophil predominant dialysate. The patient was a 63-year-old female under chronic perironeal dialysis for 2 years. She was admitted to our hospital because of intermittent fever with chills, anorexia and periumbilical abdominal fullness for two weeks. Routine dialysate examination revealed increased leukocyte count in dialysate with neutrophil predominant. MRI and laparoscope c examination found peritoneal cysts. Direct smear of the peritoneal effluent revealed acid-fast bacilli. Peritoneal fluid culture revealed mycobacteria tuberculosis. Due to persistent peritonitis and ultrafiltration inadequacy, the Tenckhoff catheter was removed and renal replacement therapy was shifted to chronic hemodialysis. We presented painless neutrophil-predominant mnycobacteria peritonitis in a patient under chronic peritoneal dialysis. The rare presentations of the complications suggested that abdominal pain could be absent and neutrophil might be predominant in mycobacteria peritonitis in a patient under chronic peritoneal dialysis.
| Original language | American English |
|---|---|
| Pages (from-to) | 207 |
| Journal | 臺灣腎臟醫學會雜誌 |
| Volume | 20 |
| Issue number | 3 |
| State | Published - 2006 |