Patients with chronic renal failure have an increased incidence of tuberculosis compared to those with normal renal function. Tuberculous peritonitis was diagnosed in five (four female; mean age: 16.3±2.1 years) of 83 patients undergoing chronic peritoneal dialysis in our department between 1996 and 2005. Three patients were undergoing continuous ambulatory peritoneal dialysis (CAPD) and two patients had been switched to hemodialysis (HD) when tuberculous peritonitis was diagnosed. The initial presentation was similar to non-mycobacterial peritonitis. In peritoneal fluid examination, all patients had predominance of lymphocytes and the mean serum to peritoneal fluid albumin ratio was 0.63±0.15. In two cases, tuberculosis culture was positive and chronic granulomatous inflammation was shown on peritoneal biopsy. In the remaining three cases, diagnosis was made by clinical and peritoneal fluid features, and radiological findings (peritoneal thickening, peritoneal septation and/or calcified mesenteric lymphadenopathies). The fevers of patients normalized after 5-7 days of anti-tuberculous treatment. In conclusion, in children on CAPD or HD (previously treated by CAPD), tuberculous peritonitis should be considered in the differential diagnosis of peritonitis, predominance of lymphocytosis in the peritoneal fluid and a prolonged course of “sterile” peritonitis unresponsive to conventional antibiotic treatment are present. When peritoneal fluid cultures for tuberculosis are negative, peritoneal biopsy and abdominal ultrasonography and/or computerized tomography may be helpful in the diagnosis.

Keywords: tüberküloz peritonit, çocuk, sürekli ayaktan periton diyalizi, hemodiyaliz, periton biyopsisi, tuberculous peritonitis, children, continuous ambulatory peritoneal dialysis, hemodialysis, peritoneal biopsy