一例血液透析开始后发生播散性结核病的病例。
A case of disseminated tuberculosis after the initiation of hemodialysis.
作者信息
Hasegawa Jumpei, Wakai Sachiko
机构信息
Department of Nephrology, Ohkubo Hospital, 2-44-1 Kabukicho, Shinjuku-ku, Tokyo, 160-8488, Japan.
出版信息
CEN Case Rep. 2013 Nov;2(2):252-255. doi: 10.1007/s13730-013-0073-2. Epub 2013 Apr 10.
A 67-year-old man with diabetes mellitus, chronic kidney disease, chronic heart failure, and amputation of the left lower limb was admitted to our hospital with decreasing renal function. On admission, he was started on hemodialysis. He simultaneously developed a urinary tract infection, infected necrotic wound of the right lower limb, and pneumonia, and was treated with broad-spectrum antibiotics. Although his general condition improved, fever and anorexia persisted and jaundice worsened. He died 138 days after admission. Autopsy revealed granulomas in the lungs, liver, and spleen. Cultures revealed Mycobacterium tuberculosis, leading to the diagnosis of disseminated tuberculosis.
一名67岁男性，患有糖尿病、慢性肾脏病、慢性心力衰竭且左下肢截肢，因肾功能下降入住我院。入院时开始进行血液透析。同时，他并发了尿路感染、右下肢感染性坏死伤口和肺炎，并接受了广谱抗生素治疗。尽管他的一般状况有所改善，但发热和厌食持续存在，黄疸加重。他在入院138天后死亡。尸检发现肺、肝和脾中有肉芽肿。培养结果显示为结核分枝杆菌，从而诊断为播散性结核病。
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