Genitourinary tuberculosis in North America: A rare clinical entity

Abstract

Introduction: Although tuberculosis (TB) is the most common cause of mortality from infectious diseases worldwide, genitourinary TB in North America is rare. We review 3 cases of genitourinary TB diagnosed within the last 5 years. Cases: The first case is that of a 76-year-old African-Canadian woman who was referred for percutaneous nephrolithotomy of right lower pole renal stones. Although renal TB was suspected, her initial urinary TB culture was negative. On follow-up imaging, she developed bilateral ureteral thickening and ureteroscopic biopsy confirmed necrotizing granulomata. Repeat urine cultures were positive for M. tuberculosis. The second case is a 73-yearold Italian-Canadian woman who was referred for ureteroscopic biopsy of left thickened ureter to rule out urothelial carcinoma. Initial urine TB cultures were negative, despite biopsies confirming granulomatous inflammation. She was closely followed with urine cytologies and TB cultures. Repeat urine culture was positive for M. tuberculosis. Both patients were treated with a course of anti-tuberculous agents and indwelling ureteral stents to relieve ureteral obstruction. The third case is a 70-year-old Cree woman who was referred for percutaneous nephrolithotomy of a left "staghorn stone" in an atrophic left kidney. Thirty years earlier she had been treated for pulmonary TB in addition to ileocystoplasty for a "thimble" bladder. A computed tomography scan showed autonephrectomized left kidney. Her urine TB cultures were negative. She was placed on prophylactic antibiotics for her recurrent bacterial urinary tract infections. Conclusion: Genitourinary TB may present in various subtle ways, and the astute clinician must have a high index of suspicion for this disease in patients with atypical clinical and radiologic findings. In addition, TB urine cultures should be repeated when there is high index of suspicion.

Tetraparesia: an unusual presentation of disseminated tuberculosis

“…Urine culture gives the definitive diagnosis, taking up to 8 weeks to become positive and with up to 20% of false negative results 11. Molecular methods, as polymerase chain reaction (not done on our patient), give faster results and has been proved to be sensitive and specific, although some false negatives occur because of urinary inhibitory substances 6 10…”

Sustained-Release Dual-Drug Ternary Salt Cocrystal of Piperazine Ferulate with Pyrazinamide: Synthesis, Structure, and Hirshfeld Surface Analysis

“…Our interest in this study originates from the following reasons. It has been found in clinical practice that chronic kidney disease (CKD) patients are susceptible infection to Mycobacterium tuberculosis due to reduced immune function of the patients, resulting in an infective complication of renal disease and tuberculosis, , and worse still, some CDK diseases and tuberculosis bear the correlation or may evolve into a complication. , The co-onset syndemic effects of renal disease and tuberculosis offer the potential requirements for novel drug combinations. Along this idea, we attempt to realize the cocrystallization of PRZ–FLA with some first-line antituberculosis drugs, such as rifampicin, isoniazid, and pyrazinamide, and meanwhile to assess the influences of cocrystallization modification on the slow-release profile of PRZ–FLA.…”

“…Our interest in this study originates from the following reasons. It has been found in clinical practice that chronic kidney disease (CKD) patients are susceptible infection to Mycobacterium tuberculosis due to reduced immune function of the patients, resulting in an infective complication of renal disease and tuberculosis, 41,42 and worse still, some CDK diseases and tuberculosis bear the correlation or may evolve into a complication. 43,44 The co-onset syndemic effects of renal disease and tuberculosis offer the potential requirements for novel drug combinations.…”

Genitourinary tuberculosis in 2-year-old indonesian boy with malnutrition: A rare case

“…This is the second most common form of extra-pulmonary tuberculosis after peripheral lymphadenopathy. 1 This study reported a rare case of genitourinary tuberculosis in 2-year-old Indonesia boy with malnutrition.…”