[Tuberculosis in hemodialysis patients in Tunisia].
BACKGROUND
Because of the immunity depression, patients with chronic renal failure undergoing haemodialysis are at increased risk for developing infections, Mycobacterium tuberculosis (MTb) in particular.


OBJECTIVE
To evaluate, in a prospective longitudinal study over 36 months period, the frequency of Tb among these patients and underline the diagnostic difficulties.


METHODS
Sixty dialysis patients were interested. The Tb assessment comprised: a questionnaire, a meticulous clinical examination, a chest X-ray, a tuberculin skin testing, as well as MT bacilli screening in biological fluids.


RESULTS
Tb was seen in six among dialysis patients(10%), this rate represents 15 times the general population tuberculosis incidence in our country (23/100,000). Tb has occurred early compared to the beginning of the haemodialysis. The Tb localizations were: 4 cases of extra-pulmonary tuberculosis (3 peritoneal and one ganglionic) and only 2 cases of pleuro-pulmonary localization. The positive diagnosis represents a real problem: no bacteriological confirmation in all patients and only in one, the histological diagnosis was obtained.


CONCLUSIONS
There was a high rate of tuberculosis in our study. The prognosis appears to be closely related to therapeutic precocity, thus specific chemotherapy started sometimes without diagnostic confirmation.
Hassine
E
E
Service de pneumologie, Hôpital A. Mami de l'Ariana. hassine.elyes@rns.tn
Marniche
K
K
Hamida
J
J
Hassine
K
K
Bouaziz
A
A
Ben Mustapha
M A
MA
Chabbou
A
A
Dhahri
M
M
D006801:Humans; D015994:Incidence; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects* / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology; D014416:Tunisia / Q000453:epidemiology