Jagodziński Jacek, Zielonka Tadeusz M
Mazowieckie Centrum Leczenia Chorób Płuc I Gróźlicy w Otwocku, Polska.
Katedra I Zakład Medycyny Rodzinnej, Warszawski Uniwersytet Medyczny, Warszawa, Polska.
Wiad Lek. 2016;69(6):825-828.
Diagnosis of tuberculosis requires bacteriological confirmation. The sputum is the material most frequently used for this purpose. In the case of extra-pulmonary tuberculosis, it is necessary to obtain other materials, such as urine, pleural fluid, pericardial effusion, ascites, cerebrospinal fluid, sample of tissue, etc. However, compared with sputum, these materials are much less likely to successfully culture mycobacteria. We described a case of a young woman with suspected pulmonary tuberculosis, however confirmation of the disease was obtained from urine culture. Despite hemoptysis and radiological changes typical for tuberculosis, the cultures of mycobacteria from respiratory tract were negative. The patient did not report any symptoms from urinary tract, and urinalysis was normal, ultrasound however revealed changes in the left kidney which were typical for tuberculosis. The mycobacterial culture of urine was positive. Antimycobacterial drugs were applied with a good effect.
结核病的诊断需要细菌学确认。痰液是最常用于此目的的材料。对于肺外结核病，有必要获取其他材料，如尿液、胸水、心包积液、腹水、脑脊液、组织样本等。然而，与痰液相比，这些材料成功培养出分枝杆菌的可能性要小得多。我们描述了一例疑似肺结核的年轻女性病例，然而该疾病是通过尿液培养得到确诊的。尽管有咯血和典型的结核病影像学改变，但呼吸道分枝杆菌培养结果为阴性。患者未报告任何泌尿系统症状，尿液分析正常，但超声显示左肾有典型的结核病改变。尿液分枝杆菌培养呈阳性。应用抗分枝杆菌药物后效果良好。
