Abstract
The patient was a female aged 61 who had been undergoing maintenance hemodialysis for 12 years. A chest X-ray during pregnancy at 21 years of age revealed a tuberculous lesion, but she did not receive specific treatment. The patient's body weight had decreased by 12kg over the preceding 3 years.
The patient was admitted with acute pulmonary edema and pneumonia, which responded to intravenous penicillin and frequent hemodialysis treatment by the 5th hospital day. Cellulitis of the left foot occurred during the screening of weight loss, and destruction of the navicular bone, the cuboid bone and the 3 cuneiform bones were noted on roentgenograms. The diagnosis of tarsal tuberculosis extending into the subcutaneous tissue was made when Mycobacterium tuberculosis was detected in pus from the lesion, and antituberculosis therapy was started. The chest X-ray and CT scan did not reveal any evidence of an acute tuberculous process, but a small number of tubercle bacilli were detected in the sputum. The patient was transferred to a special hospital for tuberculosis.
This is the first report ever of tarsal tuberculosis in a patient on maintenance hemodialysis.
