Rivero-Rodríguez W, Navarro-Mejía JA, Camelo-Pardo G, Ramírez-Angarita DI, Pinzón-Mantilla D

Language: Spanish
References: 10
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ABSTRACT

Introduction: Tuberculosis is responsible for the majority of deaths associated with infectious disease. The main involvement in the lung followed by extra pulmonary genitorurinary location, with a predominance of the kidney, epididymis and prostate respectively. The symptoms are nonspecific, suspected in patients with chronic pathologies or a previous diagnosis of pulmonary tuberculosis. The Gold Standard is the identification of the Bacillus in urine or infrequent techniques such as tuberculin injection. In diagnosed patients, treatment is based on 4 drugs (isoniazid, rifampicin, ethambutol and pyrazinamide) up to combined therapies, the duration of treatment is according to the symptoms and characteristics of the patient.
Objective: We present the case of a young patient with spontaneous kidney rupture associated with tuberculosis who required medical treatment and emergency surgical intervention, presenting multisystemic deterioration associated with hemodynamic shock. Emphasizing the importance of timely differential diagnosis, immediate pharmacological and surgical interventions in patients with renal trauma with clinical deterioration.
Conclusion: Genitourinary tuberculosis is characterized by a nonspecific clinical picture making timely diagnosis difficult, the symptoms are related to the compromised organ, suspecting in patients with chronic, nutritional and immunodeficiency alterations, being of vital importance a rapid diagnosis and effective treatment evaluating each patient individually. In this report, a patient with multiple antecedents presents a complication of renal tuberculosis not described in the literature, with immediate surgical intervention and deterioration in her clinical evolution.

REFERENCES

1. Yadav S, Singh P, Hemal A, Kumar R. Genital tuberculosis: current status of diagnosis and management. Transl Androl Urol. 2017;6(2):222–33. doi: 10.21037/ tau.2016.12.04

2. Kulchavenya E, Kholtobin D, Shevchenko S. Challenges in urogenital tuberculosis. World J Urol. 2020;38(1):89–94. doi: 10.1007/s00345- 019-02767-x

3. Rodriguez-Takeuchi SY, Renjifo ME, Medina FJ. Extrapulmonary Tuberculosis: Pathophysiology and Imaging Findings. RadioGraphics. 2019;39(7):2023–37. doi: 10.1148/rg.2019190109

4. Cao Y, Fan Y, Chen Y, Zhao Z, Song Y, Shen C, et al. Gross Hematuria Is More Common in Male and Older Patients with Renal Tuberculosis in China: A Single-Center 15-Year Clinical Experience. UIN. 2017;99(3):290–6. doi: 10.1159/000464472

5. Figueiredo AA, Lucon AM, Srougi M. Urogenital Tuberculosis. Microbiol Spectr. 2017;5(1). doi: 10.1128/microbiolspec.TNMI7-0015-2016

6. Jagodzi􀄔ski J, Zielonka TM, Pepli􀄔ska K, 􀄩yci􀄔ska K. Tuberculosis of the Urogenital Tract in Adults in a Tertiary Referral Center. Adv Exp Med Biol. 2018;1040:29–37. doi: 10.1007/5584_2017_103

7. Mondal K, Mandal R. Two unusual reports of urogenital tuberculosis: One ‘putty’ kidney and another in association with benign prostatic hyperplasia. Indian Journal of Tuberculosis. 2018;65(4):356–9. doi: 10.1016/j. ijtb.2018.06.005

8. Kim EJ, Lee W, Jeong WY, Choi H, Jung IY, Ahn JY, et al. Chronic kidney disease with genitourinary tuberculosis: old disease but ongoing complication. BMC Nephrology. 2018;19(1):193. doi: 10.1186/s12882-018- 0994-2

9. Romanowski K, Clark EG, Levin A, Cook VJ, Johnston JC. Tuberculosis and chronic kidney disease: an emerging global syndemic. Kidney International. 2016;90(1):34–40. doi: 10.1016/j. kint.2016.01.034

10. Wejse C. Medical treatment for urogenital tuberculosis (UGTB). GMS Infect Dis. 2018;6:Doc04. doi: 10.3205/id000039