Urogenital Tuberculosis: Classification, Diagnosis, and Treatment

Kulchavenya, Ekaterina; Naber, Kurt G.; Johansen, Truls E. Bjerklund

doi:10.1016/j.eursup.2016.04.001

Cited by 38 publications

(42 citation statements)

References 23 publications

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“…2 , Pamela Tarazona-Jiménez, MD. 3 , Alfredo Ortiz-Azuero, MD., Esp. 4 intraoperatorios de engrosamiento del epidídimo derecho, y drenaje de material caseoso y purulento.…”

Section: Hidrocele Como Manifestación Inicial De Tuberculosis Genitourinaria Y Miliarunclassified

Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar

Álvarez-Jaramillo

Zableh

Tarazona-Jiménez

et al. 2019

MedUNAB

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Introducción. La tuberculosis es una enfermedad infectocontagiosa que puede afectar cualquier órgano del cuerpo, incluyendo el sistema genitourinario, representando el 33.7-45.5 % de las tuberculosis extrapulmonares. El objetivo de este trabajo es reportar el caso de un paciente con hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar, enfermedad que no se sospechaba. Presentación del caso. Paciente masculino previamente sano, que consulta a urgencias por orquialgia e hidrocele bilateral, con secreción purulenta por escroto, requiriendo manejo antibiótico intravenoso e hidrocelectomía derecha, con hallazgos intraoperatorios de engrosamiento del epidídimo derecho, y drenaje de material caseoso y purulento. Se realizó epididimectomía ipsilateral, se solicitaron pruebas de detección de bacilos tuberculosos en espécimen y derivado proteico purificado, que fueron positivas. En el postoperatorio presentó sintomatología respiratoria; paraclínicos evidenciaron compromiso pulmonar, pleural y de la vía urinaria por bacilos tuberculosos. Se inicia manejo antituberculoso con evolución satisfactoria. Discusión. El genitourinario es considerado el segundo sistema con mayor afectación de tuberculosis extrapulmonar. El órgano más afectado es el riñón (en un 80 % con respecto a los demás) y el órgano genital es el epidídimo (22 - 55 %). Debe sospecharse en pacientes con síntomas urinarios crónicos sin causa aparente. Se asocia a una alta tasa de morbimortalidad por infertilidad y falla renal. Conclusiones. A pesar de su sintomatología inespecífica y de tratarse de una entidad poco sospechada, la tuberculosis genitourinaria debe descartarse al existir tuberculosis pulmonar. Su diagnóstico y tratamiento oportuno serán de gran importancia para evitar complicaciones secundarias.

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“…2 , Pamela Tarazona-Jiménez, MD. 3 , Alfredo Ortiz-Azuero, MD., Esp. 4 intraoperatorios de engrosamiento del epidídimo derecho, y drenaje de material caseoso y purulento.…”

Section: Hidrocele Como Manifestación Inicial De Tuberculosis Genitourinaria Y Miliarunclassified

Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar

Álvarez-Jaramillo

Zableh

Tarazona-Jiménez

et al. 2019

MedUNAB

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“…Standard treatment duration is two months of intensive phase with all four drugs daily, followed by 4 or 7 months of continuation phase with only two drugs (INH+RIF), in total 6–9 months. Appropriate treatment with standard antituberculous agents for six months is usually successful in eradicating active UGTB, provided that it is drug-susceptible TB [ 1 ], and this is the general recommended duration of treatment [ 2 ], [ 3 ]. The 4-month continuation phase should therefore be used in the large majority of patients, the 7-month continuation phase should be reserved only for special groups of patients, such as patients with cavitary pulmonary TB with a positive sputum culture after the initial 2-month treatment.…”

Section: Medical Treatmentmentioning

confidence: 99%

“…It is caused by inflammation, followed by fibrosis and obstruction of the collecting system [ 16 ]. Ureteral strictures may be caused by the disease process prior to treatment, but may also progress during treatment due to scarring and subsequent narrowing of the lumen [ 3 ]. Usually, this is occurring within the first two months of treatment [ 22 ].…”

Section: Complications During Treatmentmentioning

confidence: 99%

“…Some reports indicate a very frequent need for surgery, up to 32% of male cases with UGTB in a large India cohort [ 4 ]. When urinary tract obstructions occur, anti-tuberculous treatment is not always sufficient, and reconstructive surgery may be indicated [ 3 ]. When UGTB has led to major kidney lesions such as caverns, surgical intervention is indicated in advanced cases [ 24 ].…”

Section: Treatment Of Complicationsmentioning

confidence: 99%

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Medical treatment for urogenital tuberculosis (UGTB)

Wejse

2018

GMS Infectious Diseases; 6:Doc04

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“…Additionally, the frequency of AFB positivity in urine smears is very low . Besides urine cytology, a number of other tests are also available to establish a diagnosis of urinary tract TB, including urine culture (solid as well as liquid culture methods), urine polymerase chain reaction for Mycobacterium tuberculosis , real‐time nucleic acid amplification technology, interferon‐gamma release assay and antigen detection tests . The present case demonstrates the typical cytomorphologic features of urinary TB and highlights the diagnostic utility of urine cytology and ZN staining in establishing the diagnosis, especially in resource‐poor settings.…”

mentioning

confidence: 99%

‘Forget me not’: Urine cytology in a male with hematuria

Gupta

Rajwanshi

2019

Cytopathology

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Forget me not': Urine cytology in a male with hematuria | C A S E HIS TORY• 41-year-old male.• Presented with painless hematuria with occasional passage of clots over the last 2 months. Enigma Portal A Urine culture. B Acid fast bacilli positivity. C Polymerase chain reaction. D All of the above. 4. Acid fast bacilli can be demonstrated on urine cytology in what proportion of these cases? A 80%-100%. B 25%-42%. C 50%-70%. D 1%. Tuberculosis (TB) of the urinary tract, although rare in the west, is still a common disease in developing countries of the world. Urinary tract TB includes infection of the real pelvis, ureters, urinary bladder and/or urethra and invariably occurs as a complication of renal TB. Owing to the variable clinical presentations of the disease, establishing a diagnosis is often challenging and a high index of suspicion is required. Early diagnosis of the disease is the key to better patient outcome as progression of the disease leads to irreversible damage to the affected organs. Urine cytology is an indispensable and the most inexpensive method for establishing a diagnosis of a wide variety of non-neoplastic as well as neoplastic diseases involving the urinary tract. However, the reported sensitivity of urine cytology for diagnosing TB is variable with scattered reports depicting the cytologic findings. 3 Cytologic diagnosis of TB on urine smears requires presence of epithelioid cell granulomas and scattered multinucleated Langhans' type giant cells in an often dirty background with variable numbers of inflammatory cells including neutrophils and lymphocytes along with demonstration of acid fast bacilli (AFB) on Ziehl-Neelson (ZN) staining. However, since the presence of epithelioid cell granulomas in urine is uncommon, the less experienced pathologists fail to identify these on urine smears. Additionally, the frequency of AFB positivity in urine smears is very low. 4 Besides urine cytology, a number of other tests are also available to establish a diagnosis of urinary tract TB, including urine culture (solid as well as liquid culture methods), urine polymerase chain reaction for Mycobacterium tuberculosis, real-time nucleic acid amplification technology, interferon-gamma release assay and antigen detection tests. 5 The present case demonstrates the typical cytomorphologic features of urinary TB and highlights the diagnostic utility of urine cytology and ZN staining in establishing the diagnosis, especially in resourcepoor settings.

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Urogenital Tuberculosis: Classification, Diagnosis, and Treatment

Cited by 38 publications

References 23 publications

Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar

Hidrocele como manifestación inicial de tuberculosis genitourinaria y miliar

Medical treatment for urogenital tuberculosis (UGTB)

‘Forget me not’: Urine cytology in a male with hematuria

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