An unusual case of peritonitis.
Though peritonitis is a common complication in Continuous Ambulatory Peritoneal Dialysis (CAPD), tuberculous peritonitis has been reported in only twelve CAPD patients in the world English literature to date. Successful outcome in those reported cases involved antituberculous therapy and in the majority, catheter removal and conversion to maintenance haemodialysis. We report in this article our first case of tuberculous peritonitis in a CAPD patient. The diagnosis was made at laparotomy in our patient and she improved with antituberculous therapy. CAPD was continued without interruption. In haemodialysis patients, mortality from tuberculosis is reported to be high due to atypical presentation and delay in diagnosis. To avoid this delay, we recommend that the clinician have high index of suspicion for tuberculous peritonitis in CAPD patients with sterile peritonitis. Early diagnosis carries a good prognosis, and CAPD need not necessarily be discontinued in these patients.
Vathsala
A
A
Department of Renal Medicine, Singapore General Hospital.
Thomas
A
A
Ng
B L
BL
Lim
C H
CH
D005260:Female; D006801:Humans; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014395:Peritonitis, Tuberculous