Korean Journal of Nephrology 2001;20(2):332-336.

증례 : 혈액투석 환자에서 발생한 속립성 폐결핵과 동반된 결핵성 간농양 1 예 및 투석환자의 결핵에 대한 문헌고찰 (Hepatic Tuberculous Abscess and Miliary Tuberculosis in A Hemodialysis Patient)

문계혁(Gae Hyuk Moon),송준호(Joon Ho Song),이승우(Seoung Woo Lee),이경주(Kyong Ju Lee),박현신(Hyun Sin Park),김문재(Moon Jae Kim)

Abstract

The impairment of host defense mechanisms, particularly of cellular immunity, causes high incidence of mycobacterial infections in the patients with ESRD. Extrapulmonary mycobacterial infections are more frequent in ESRD patients compared to general population. However, there has been rarely reported on the occurrence of hepatic tuberculous abscess as an extrapulmonary mycobacterial infection in ESRD patients. We present a case of ESRD patient manifesting miliary tuberculosis and hepatic tuberculous abscess, which have successfully resolved after antituberculous medications. A 44 years old male admit- ted with fever, general weakness, night sweating, and cough. Chest X-ray and abdominal CT revealed pulmonary miliary tuberculosis and a solitary tuberculous abscess at S7 of right hepatic lobe with multiple periportal and celiac lymphadenopathy. After the administration of anti-tuberculous medications(isoniazid, rifampicin, ethambutol - eight month, pyrazinamide - two month), miliary tubuculosis disappeared. The size of hepatic tuberculous abscess and lymphadenopathy were reduced in abdominal CT six month later. The patient is followed in outpatient without noticeable symptoms after eight month treatment.