[Tuberculosis in hemodialysis patients in Tunisia].

BACKGROUND

Because of the immunity depression, patients with chronic renal failure undergoing haemodialysis are at increased risk for developing infections, Mycobacterium tuberculosis (MTb) in particular.

OBJECTIVE

To evaluate, in a prospective longitudinal study over 36 months period, the frequency of Tb among these patients and underline the diagnostic difficulties.

PATIENTS AND

METHODS

Sixty dialysis patients were interested. The Tb assessment comprised: a questionnaire, a meticulous clinical examination, a chest X-ray, a tuberculin skin testing, as well as MT bacilli screening in biological fluids.

RESULTS

Tb was seen in six among dialysis patients(10%), this rate represents 15 times the general population tuberculosis incidence in our country (23/100,000). Tb has occurred early compared to the beginning of the haemodialysis. The Tb localizations were: 4 cases of extra-pulmonary tuberculosis (3 peritoneal and one ganglionic) and only 2 cases of pleuro-pulmonary localization. The positive diagnosis represents a real problem: no bacteriological confirmation in all patients and only in one, the histological diagnosis was obtained.

CONCLUSION

There was a high rate of tuberculosis in our study. The prognosis appears to be closely related to therapeutic precocity, thus specific chemotherapy started sometimes without diagnostic confirmation.