[症例報告]試験開腹により診断がついた結核性腹膜炎を生じたCAPD患者の一例

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We report a case of tuberculous peritonitis diagnosed by preparatory laparotomy in a patient with end-stage renal failure complicating continuous ambulatory peritoneal dialysis (CAPD). A-73-year old man was admitted to our hospital because of peritonitis. Therapy with antibiotics for three weeks resulted in a almost complete resolution. However, he complained of cough and chill with ascites on day 74. A conventional treatment with antibiotics was not effective for these symptoms. A diagnosis of tuberculous peritonitis was finally made by pleural biopsy. Immediately, anti-tuberculosis therapy consisting of isoniazid (300 mg/day), rifampicin (450mg/day), streptomycin sulfate (500mg/ 3 day) and ethambutol hydrochloride (500mg/day) was started. His clinical symptoms improved but he died due to the complication of multiple organ failure on day 193 0f the hospital. In CAPD patients with fever of unknown origin and ascites, tuberculous peritonitis should be considered as a potential cause.
琉球医学会,Ryukyu Medical Associationの論文