title: Extrapulmonary tuberculosis in a hemodialysis patient with unusual clinical presentation.
abstract: The incidence of active tuberculosis in patients undergoing maintenance dialysis for a long time is considerably higher than that in general population. A 39-year-old male treated by hemodialysis three times a week for six months was admitted to the hospital with a painless mass palpable under his right areola. X-ray examination of chest showed a hyperintense lesion. Computed tomography revealed a cystic mass in the superior segment of inferior lobe near the thoracic vertebrae. Needle aspiration of the lesion revealed granulomas and acid-resistant bacteria. Anti-tuberculous therapy was therefore initiated. After eight months the patient was admitted back with paraplegia. Magnetic resonance imaging (MRI) revealed that the lesion defined by computed tomography (CT) was extending to the spinal duct and compressing the spinal cord. A tissue biopsy was performed and granulomas were identified. Mycobacterium tuberculosis grew in the culture. This case suggests that in areas with a high incidence of tuberculosis renal patients in a high-risk group should be examined periodically to exclude insidious infection and reduce morbidity and mortality.
authors.affiliation: Department of Nephrology, Kayseri State Hospital, Kayseri, Turkey. savtansu@gmail.com
authors.forename: Tansu
authors.initials: T
authors.lastname: Sav
authors.forename: Bulent
authors.initials: B
authors.lastname: Tokgoz
authors.forename: Murat H
authors.initials: MH
authors.lastname: Sipahioglu
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Mavili
authors.forename: Oktay
authors.initials: O
authors.lastname: Oymak
authors.forename: Cengiz
authors.initials: C
authors.lastname: Utas
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000175:diagnosis*; D014399:Tuberculosis, Spinal / Q000150:complications / Q000175:diagnosis*