| [ Summary ] |
The incidence rate of tuberculosis (TB) in dialysis patients is much higher than in the general population, and is characterized by a high prevalence of extrapulmonary and miliary TB. An 81-year-old female dialysis patient who received prednisolone for bullous pemphigoid developed a fever and exhibited elevated C-reactive protein levels. Chest computed tomography revealed randomly distributed miliary nodules in both the lungs. She was referred to a pulmonary specialist, and a diagnosis of TB was established based on sputum and gastric fluid analysis. Treatment with isoniazid 150 mg/day, rifampicin 300 mg/day, and ethambutol 500 mg after every dialysis session was started, and the patient recovered. It is important to have a high index of suspicion for TB in elderly dialysis patients to ensure early diagnosis and treatment because miliary TB may develop from reactivation of old tuberculosis lesions in patients who are immunocompromised or are on dialysis. |