Renal Tuberculosis

Gibson, Michael S.; Puckett, Michael L.; Shelly, Mark E.

doi:10.1148/rg.241035071

Cited by 94 publications

(93 citation statements)

References 15 publications

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“…1,6 This is why renal involvement is the most affected organ in genitourinary TB. In immune-competent patients, these granulomas may stay latent for many years.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Imaging findings are also non-specific and may even further delay diagnosis. 6 The astute clinician must have a high degree of suspicion for genitourinary TB in patients presenting with non-specific symptoms, culture-negative pyuria, and for whom imaging studies seem atypical. We present 3 cases of genitourinary TB clinically diagnosed by a urologist within the last 5 years; these cases remind clinicians of this rare but existing clinical condition in North America.…”

Section: Introductionmentioning

confidence: 99%

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Genitourinary tuberculosis in North America: A rare clinical entity

Sourial

Brimo²,

Horn³

et al. 2015

CUAJ

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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.

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“…1,6 This is why renal involvement is the most affected organ in genitourinary TB. In immune-competent patients, these granulomas may stay latent for many years.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Genitourinary tuberculosis in North America: A rare clinical entity

Sourial

Brimo²,

Horn³

et al. 2015

CUAJ

View full text Add to dashboard Cite

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“…Tuberculosis (TB) is a current public health problem, remaining the most common worldwide cause of mortality from infectious disease, with an estimated global incidence of 8 to 10 million/year 7,9,10,16,22 .…”

Section: Introductionmentioning

confidence: 99%

“…Untreated lesions enlarge and a tubercular abscess may form in the parenchyma. Later on, perinephric abscess is formed and the kidney is replaced by caseous material ("putty kidney") which may become calcified ("cement kidney") and nonfunctional leading to renal failure 9 .…”

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confidence: 99%

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Review of genitourinary tuberculosis with focus on end-stage renal disease

Lima

Vasconcelos²,

Filgueira

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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SUMMARYTuberculosis (TB) is a current public health problem, remaining the most common worldwide cause of mortality from infectious disease. Recent studies indicate that genitourinary TB is the third most common form of extra-pulmonary disease. The diagnosis of renal TB can be hypothesized in a non-specific bacterial cystitis associated with a therapeutic failure or a urinalysis with a persistent leukocyturia in the absence of bacteriuria. We report on the case of a 33-year-old man who presented on admission end stage renal disease (ESRD) secondary to renal TB and a past history of pulmonary TB with important radiologic findings. The diagnosis was based on clinical findings despite all cultures being negative. Empiric treatment with tuberculostatic drugs was started and the patient became stable. He was discharged with no symptom, but without renal function recovery. He is on maintenance hemodialysis three times a week. TB is an important cause of kidney disease and can lead to irreversible renal function loss.

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