Early diagnosis of tuberculous peritonitis in peritoneal dialysis patients using the T-SPOT test

Naoto Okubo; Tatsuya Suwabe; Masayuki Yamanouchi; Daisuke Ikuma; Hiroki Mizuno; Yuki Oba; Katsuyuki Miki; Takayoshi Yokoyama; Yasuo Ishii; Naoki Sawa; Yuki Nakamura; Hisashi Takaya; Yoshifumi Ubara

doi:10.1007/s13730-024-00882-2

Early diagnosis of tuberculous peritonitis in peritoneal dialysis patients using the T-SPOT test

CEN Case Rep. 2024 Apr 21. doi: 10.1007/s13730-024-00882-2. Online ahead of print.

Authors

Affiliations

¹ Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan. onaoto28@gmail.com.
² Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan.
³ Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan.
⁴ Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan. ubara@toranomon.gr.jp.

PMID: 38643328
DOI: 10.1007/s13730-024-00882-2

Abstract

A 49-year-old man was admitted with peritonitis nine months after starting continuous ambulatory peritoneal dialysis (CAPD) for kidney failure. Ceftazidime and cefazolin were started. Peritoneal dialysate culture was negative for bacteria, but antibiotic treatment was continued because peritonitis improved. Twenty days later, the patient was discharged with no signs of peritonitis. However, 40-day culture of the original peritoneal dialysate detected Mycobacterium tuberculosis, and peritonitis recurred, leading to readmission. A T-SPOT test was performed and was positive in 4 days. Anti-tuberculosis therapy was started, which cured the peritonitis. The T-SPOT test may enable early diagnosis of tuberculosis.

Keywords: Peritoneal dialysis; T-SPOT test; Tuberculous peritonitis.