Portal de investigação
Clearing the clouds: Case-report and review of the literature
Autores da FMUP
Participantes de fora da FMUP
- Relvas, M
- Beco, A
- Pereira, L
- Oliveira, A
- Silvano, J
- Silva, R
- Marques, N
- Santos, L
- Coentrao, L
Unidades de investigação
Abstract
In peritoneal dialysis (PD), a cloudy dialysate is an alarming finding. Bacterial peritonitis is the most common cause, however, atypical infections and non-infectious causes must be considered. A 46-year-old man presented with asthenia, paraesthesia, foamy urine and hypertension. Laboratory testing revealed severe azotaemia, anaemia, hyperkalaemia and nephrotic-range proteinuria. Haemodialysis was started through a central venous catheter. Later, due to patient preference, a Tenckhoff catheter was inserted. Conversion to PD occurred 3 weeks later, during hospitalization for a presumed central line infection. A month later, the patient was hospitalized for neutropenic fever. He was diagnosed an acute parvovirus infection and was discharged under isoniazid for latent tuberculosis. Four months later, the patient presented with fever and a cloudy effluent. Peritoneal fluid (PF) cytology was suggestive of infectious peritonitis, but the symptoms persisted despite antibiotic therapy. Bacterial and mycological cultures were negative. No neoplastic cells were detected. Mycobacterium tuberculosis eventually grew in PF cultures, despite previous negative molecular tests. Directed therapy was then initiated with excellent response. Thus, facing a cloudy effluent, one must consider multiple aetiologies. Diagnosis of peritoneal tuberculosis is hampered by the lack of highly sensitive and specific exams. Here, diagnosis was only possible due to positive mycobacterial cultures.
© 2020 Wiley Periodicals LLC.
Dados da publicação
- ISSN/ISSNe:
- 1525-139X, 0894-0959
- Tipo:
- Review
- Páginas:
- 83-88
- DOI:
- 10.1111/sdi.12931
- Link para outro recurso:
- www.scopus.com
Seminars in Dialysis Wiley-Blackwell Publishing Ltd
Citações Recebidas na Web of Science: 1
Citações Recebidas na Scopus: 2
Documentos
- Não há documentos
Filiações
Keywords
- cloudy dialysate; isoniazid‐ resistant tuberculosis; peritoneal dialysis; peritoneal tuberculosis; peritonitis
Proyectos asociados
Rituximab na terapêutica da nefropatia membranosa
Investigador Principal: Manuel Jesus Falcão Pestana Vasconcelos
Estudo Clínico Académico (Rituximab) . 2020
Citar a publicação
Relvas M,Beco A,Pereira L,Oliveira A,Silvano J,Silva R,Marques N,Santos L,Coentrao L,Pestana M. Clearing the clouds: Case-report and review of the literature. Semin. Dialysis. 2021. 34(1):p. 83-88. IF:2,886. (3).
