Abstract
Infections, particularly tuberculosis, are the most frequent cause of fever of unknown origin in patients treated by maintenance hemodialysis. We report here a case of tuberculosis of intestine, liver and peritoneum complicating hemodialysis.
A 60 year-old female was admitted to our hospital for fever of unknown origin seven months after hemodialysis was started. Abdominal echotomography showed a tumor (5×5cm) in the ileocecal region. Laparotomy disclosed multiple small white nodules on the intestinal serosa, parietal peritoneum and liver. There was also a penetrating ulcer at the ileocecum.
Frozen and permanent sections of peritoneal and liver nodules showed typical features of the tuberculosis Including caseous necrosis, surrounded by epithelioid cells, mononuclear cells, and Langhans-type giant cells.
We performed an ilocecal resection operation. Tuberculosis cultures of the resected ileocecal and liver specimens showed positive bacilli. Thirty-nine days after the operation the patient has transferred to a special tuberculosis hospital.
