Abstract
A case of tuberculous peritonitis in a CAPD patient cured without catheter removal is reported. A 43-year-old woman was started on CAPD in June, 1992. She developed a spiking fever on September 4, 1992. The peritoneal WBC count was 49/mm3. She was treated with antibiotics but without success. The peritoneal WBC count increased to more than 1, 000/mm3, but repeated cultures for bacteria and smears for acid-fast bacilli were negative. The Mantoux test was strongly positive. Chest CT showed multiple lymphadenopathies of the mediastinum. Because of the suspicion of tuberculous infection, antituberculous therapy (INH, RFP) was commenced on September 15. The fever began to subside the next day, followed by a gradual decrease in the peritoneal WBC count. The culture done on September 16 subsequently revealed Mycobacterium tuberculosis.
Tuberculosis should be considered in CAPD patients who have unresolved peritonitis. Early diagnostic treatment saved the catheter in the present case.
