title: Fatal hepatic failure caused by miliary tuberculosis in a hemodialysis patient: case report.
abstract: A 57 year-old male dialysis patient died soon after the onset of high fever, hypoglycemia, and disturbance of consciousness. Autopsy revealed granulomatous lesions associated with caseous necrosis mainly found in the liver, despite the absence of pulmonary changes on chest radiographs performed during the patients illness. It appears that tubercle bacilli were hematogenously disseminated mainly to the liver causing miliary tuberculosis without producing typical diffuse lesions in the lungs. Since tuberculosis is a common complication in hemodialysis patients, the potential development of atypical miliary tuberculosis should always be borne in mind.
authors.affiliation: Hakuai Hospital, Hiroshima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kushihata
authors.forename: N
authors.initials: N
authors.lastname: Yorioka
authors.forename: Y
authors.initials: Y
authors.lastname: Nishida
authors.forename: D
authors.initials: D
authors.lastname: Amimoto
authors.forename: T
authors.initials: T
authors.lastname: Takasugi
authors.forename: K
authors.initials: K
authors.lastname: Taniyama
authors.forename: M
authors.initials: M
authors.lastname: Yamakido
mesh_terms: D001344:Autopsy; D017809:Fatal Outcome; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D013902:Radiography, Thoracic; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis / Q000473:pathology