Unusual Case of Tuberculosis in Hemodialysis Patient-Tuberculoma Involving Right Atrium.
- Author:
Young Ok KIM
1
;
Seong Won CHO
;
Sang Il KIM
;
Young Shin SHIN
;
Chul Woo YANG
;
Dong Heon KANG
;
Young Pil WANG
;
Kyu Bo CHOI
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, College of Medicine, Catholic University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Tuberculosis;
Right atrium;
hemodialysis;
Chronic renal failure
- MeSH:
Diagnosis;
Echocardiography;
Fever of Unknown Origin;
Follow-Up Studies;
Granuloma;
Heart Atria*;
Humans;
Incidence;
Kidney;
Kidney Failure, Chronic;
Mediastinum;
Meninges;
Pericardial Effusion;
Pericardium;
Peritoneum;
Pleura;
Renal Dialysis*;
Thoracotomy;
Tomography, X-Ray Computed;
Tuberculoma;
Tuberculosis*;
Weight Loss
- From:Korean Journal of Nephrology
1997;16(1):183-187
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
There is a high incidence of tuberculosis in patients with chronic renal failure undergoing hemodialysis. Clinical features and laboratory findings are intermittent high fever of unknown origin, weight loss, high ESR and CRP. The diagnosis of tuberculosis in patients with hemodialysis can be difficult due to non specific symptoms, insidious onset, and unusually high frequency of extrapulmonary involvement. Sites of extrapulmonary involvement include mediastinum, meninges, pleura, kidney, peritoneum, and rarely pericardium. We experienced a unusual case of tuberculoma involving the right atrium in a hemodialysis patient. Our initial impression of this case was pericardial effusion. However, chest CT and echocardiography revealed a mass on the right atrium. Exploratory thoracotomy revealed tuberculous granuloma scattered throughout pericardium and tuberculoma involving right atrium. Following the administration of anti Tbc medication, clinical symptoms and signs resolved and follow up chest CT showed significant decrease in the size of the tuberculoma.
