Tuberculosis in nephrologist’s practice (Cases report)

Abstract

Infectious diseases are often complicate the course of the main kidney disease in nephrological practice. Patients on long-term immunosuppressive therapy or renal replacement therapy are under serious risk of infectious complications. Particular attention is paid to specific infection - tuberculosis. This group of patients often develop mycobacteriosis caused by atypical mycobacteria, which become pathogenic due to immunodeficiency. Diagnosis of mycobacteriosis can be problematic as it requires special laboratory methods which are not available in routine clinical practice. We discuss the difficulties of diagnostics and treatment of tuberculosis in patients with diabetic nephropathy and chronic glomerulonephritis. The clinical cases show specific symptoms of tuberculosis intoxication and respiratory disorders, the lack of non-specific antibacterial therapy with the fatal multi-organ failure and death. A long unclear fevered period in immunocompromised patients is an absolute indication for persistent and probably repeated examination for exclusion of non-specific or specific infec-tious process. The main methods of diagnosis of pulmonary tuberculosis are still x-rays with the obligatory CT and sputum seed.