FATAL HEPATIC-FAILURE CAUSED BY MILIARY TUBERCULOSIS IN A HEMODIALYSIS PATIENT - CASE-REPORT

A 57 year-old male dialysis patient died soon after the onset of high fever, hypoglycemia, and disturbance of consciousness. Autopsy reveale d granulomatous lesions associated with caseous necrosis mainly found in the liver, despite the absence of pulmonary changes on chest radiog raphs performed during the patients illness. It appears that tubercle bacilli were hematogenously disseminated mainly to the liver causing m iliary tuberculosis without producing typical diffuse lesions in the l ungs. Since tuberculosis is a common complication in hemodialysis pati ents, the potential development of atypical miliary tuberculosis shoul d always be borne in mind.