Tuberculous lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis.
The aim of this study was to review the clinical features of tuberculous (TB) lymphadenitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Nine cases of TB lymphadenitis were diagnosed among 910 patients over a period of 10 years. There were five men and four women with a mean age of 51 +/- 15.5 years. The TB lymphadenitis involved the cervical lymph nodes in six patients, supraclavicular lymph nodes in two patients and mediastinal lymph nodes in one patient. Six patients presented with clinically enlarged lymph nodes of whom four also had fever. Three other patients were incidentally found to have enlarged lymph nodes on routine chest X-ray or ultrasound examination of the neck. Diagnosis of TB lymphadenitis was made by demonstrating caseating granulomata with or without positive acid-fast bacilli on excisional lymph node biopsy. All patients were cured with standard anti-tuberculosis drugs for 12 months. No recurrence of the TB lymphadenitis was observed after a mean follow-up of 59 +/- 30 months. We conclude that TB lymphadenitis is not uncommon among patients on CAPD. A high index of suspicion is needed for early diagnosis of this condition. Prompt initiation of anti-tuberculosis treatment is associated with good prognosis.
Lui
Sing Leung
SL
Department of Medicine, The University of Hong Kong, Tung Wah Hospital, 12, Po Yan Street, Sheung Wan, Hong Kong SAR, PR China. sllui@hku.hk
Yip
Terence
T
Tse
Kai Chung
KC
Chan
Tak Mao
TM
Lai
Kar Neng
KN
Lo
Wai Kei
WK
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009333:Neck; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000209:etiology