Tuberculous peritonitis is a rare complication during peritoneal dialysis (PD). This report presents the case of a patient with clinical signs and symptoms indicative of bacterial peritonitis, but without culture growth of conventional bacteria or fungi. Cytokine flow cytometry after overnight stimulation of cells from peripheral blood and the peritoneal dialysate with Mycobacterium tuberculosis (MTB)-specific antigens revealed a 40-fold increase in MTB-specific CD4 + T cells expressing interferon-γ (IFN-γ) in peritoneal fluid compared with blood, which was indicative of active tuberculosis (TB). The presence of TB was later confirmed by polymerase chain reaction and growth of MTB in culture of the dialysate. The case illustrates the usefulness of MTB-specific immunodiagnosis for the rapid identification of peritoneal TB in PD patients.
Keyphrases
- mycobacterium tuberculosis
- peritoneal dialysis
- end stage renal disease
- pulmonary tuberculosis
- flow cytometry
- peripheral blood
- dendritic cells
- chronic kidney disease
- case report
- immune response
- emergency department
- loop mediated isothermal amplification
- hepatitis c virus
- depressive symptoms
- hiv infected
- bioinformatics analysis
- prognostic factors
- real time pcr
- patient reported