Early diagnosis of tuberculous peritonitis in peritoneal dialysis patients using the T-SPOT test

CEN Case Rep. 2024 Dec;13(6):499-503. doi: 10.1007/s13730-024-00882-2. Epub 2024 Apr 21.

Abstract

A 49-year-old man was admitted with peritonitis nine months after starting continuous ambulatory peritoneal dialysis (CAPD) for kidney failure. Ceftazidime and cefazolin were started. Peritoneal dialysate culture was negative for bacteria, but antibiotic treatment was continued because peritonitis improved. Twenty days later, the patient was discharged with no signs of peritonitis. However, 40-day culture of the original peritoneal dialysate detected Mycobacterium tuberculosis, and peritonitis recurred, leading to readmission. A T-SPOT test was performed and was positive in 4 days. Anti-tuberculosis therapy was started, which cured the peritonitis. The T-SPOT test may enable early diagnosis of tuberculosis.

Keywords: Peritoneal dialysis; T-SPOT test; Tuberculous peritonitis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use
  • Early Diagnosis*
  • Humans
  • Interferon-gamma Release Tests / methods
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis* / isolation & purification
  • Peritoneal Dialysis, Continuous Ambulatory* / adverse effects
  • Peritonitis, Tuberculous* / diagnosis
  • Peritonitis, Tuberculous* / drug therapy

Substances

  • Antitubercular Agents
  • Anti-Bacterial Agents