Dialysis patients showed a high susceptibility to miliary tuberculosis and if once affected, the fatality was high. In order to clarify the characteristics of miliary tuberculosis in dialysis patients, a statistical study was done.
The subjects were 7274 dialysis patients in 161 institutions including 150 cases complicated with tuberculosis. Among them 9 males and 6 females were miliary tuberculosis. They were between 30 to 69 years of age. Seven males and six females died of it.
As to the causative diseases for renal failure, pyelonephritis and polycystic kidney were seen more frequently among the patients with milialy tuberculosis than among all tuberculosis patients receiving dialysis.
The attack rate of miliary tuberlcuosis showed a rise from 3 months prior to the initiation of dialysis therapy, and it was highest during the initial 3 months of dialysis therapy, then it went down gradually, although it remained much higher during dialysis therapy than that of the general population.
Lung was involved most frequently, next liver and spleen, then followed by bone-joint, lymphnode, kidney and urinary tract, pancreas, pleura, gut, bone marrow, peritoneum, trachea, adrenal, meninges and pericardium. Almost all organs except muscle, brain and thyroid were involved.
Fever was the most common one among the symptoms and signs which lead to the diagnosis, then followed by anorexia, weakness, fatigue, weightloss, cough, abdominal pain, etc. Chest X-ray was useful for diagnosis in 6 cases among 11 patients. Tubercle bacilli were detected in 3 cases. Autopsy was perfomed in 11 cases. Among them 7 cases were proved to be miliary tuberculosis at autopsy.
Seven patients had 8 episodes of tuberculosis in total. They occurred 22. 1 years ago in average.
The present study demonstrated the characteristics of miliary tuberculosis among dialysis patients.
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