Division of Nephrology, Department of Internal Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Am J Trop Med Hyg. 2011 Jun;84(6):843-4. doi: 10.4269/ajtmh.2011.11-0014.
Extrapulmonary tuberculosis (TB) account for approximately 15-20% of TB cases in immunocompetent patients. The genitourinary system is the third most commonly affected site. We report the case of a 20-year-old man admitted with fever, chills, dry cough, right flank pain, and oliguria who developed renal function loss. The pyelogram evidenced silence of the right kidney, and the abdominal and pelvic magnetic resonance showed significant dilation of the right pyelocaliceal system and proximal ureter. Biopsies of renal cortex and retroperitoneal lymph nodes showed caseous granuloma consistent with TB. Treatment was started with rifampicin, isoniazid, pyrazinamide, and ethambutol, and the patient presented a favorable outcome but with non-dialytic chronic kidney disease. This case illustrates a case of chronic kidney disease secondary to TB in a young, otherwise healthy man.
肺外结核（TB）约占免疫功能正常患者中 TB 病例的 15-20%。泌尿系统是第三大常受累部位。我们报告了一例 20 岁男性患者，因发热、寒战、干咳、右侧腰痛和少尿入院，该患者出现肾功能丧失。肾盂造影显示右肾功能丧失，腹部和盆腔磁共振成像显示右肾盂和输尿管近端显著扩张。肾皮质和腹膜后淋巴结活检显示干酪样肉芽肿，符合 TB 表现。治疗开始使用利福平、异烟肼、吡嗪酰胺和乙胺丁醇，患者的预后良好，但出现非透析性慢性肾脏病。该病例说明了一例年轻、健康的男性患者继发于 TB 的慢性肾脏病。
