Xie Junyi, Yang Fan, Xiong Gengyan, Zhu Jun, Liu Yixiao, Zhou Peimin, Li Zheng, Sun Zhoujie, Yun Yongyang, Yu Wei, Hao Han
Department of Urology, Peking University First Hospital, Beijing, 100034, China.
Department of Urology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, 510120, China.
BMC Infect Dis. 2025 Apr 21;25(1):566. doi: 10.1186/s12879-025-10885-8.
Horseshoe kidney tuberculosis (HSKTB) has been rarely reported.
We report the case of a patient who was thought to have prostatitis for 1 year, was later diagnosed with horseshoe kidney tuberculosis involving the right kidney and part of the isthmus. After consulting the surgical team, the patient chose to have laparoscopic heminephrectomy to remove the lesion and protect kidney function. He continued the 4-drug anti-tuberculosis (TB) regimen combined with antibiotics postoperatively. His body temperature peaked in the first 3 postoperative days and declined gradually from the 6 th day. After discharge, he continued anti-TB treatment at a specialized hospital, transitioning to a 2-drug regimen for one year. His body temperature returned to normal 2 months after the surgery, a delay potentially attributable to the severity of the pre-existing tuberculous infection and potential surgery-related tuberculous bacteremia. The patient subsequently returned for kidney stones, which facilitated follow-up. He reported no TB recurrence since then.
This case underscores the feasibility of surgery with drug therapy for HSKTB. Sharing of such experiences can improve clinical decision-making for this rare condition.
马蹄肾结核（HSKTB）鲜有报道。
我们报告一例患者，该患者被认为患有前列腺炎1年，后来被诊断为马蹄肾结核，累及右肾及部分峡部。在咨询外科团队后，患者选择进行腹腔镜半肾切除术以切除病灶并保护肾功能。术后他继续采用四联抗结核方案并联合使用抗生素。他的体温在术后第1个3天达到峰值，从第6天开始逐渐下降。出院后，他在专科医院继续抗结核治疗，转为二联方案治疗一年。术后2个月他的体温恢复正常，这一延迟可能归因于既往结核感染的严重程度以及潜在的手术相关结核菌血症。该患者随后因肾结石复诊，这便于进行随访。此后他报告无结核复发。
本病例强调了药物治疗联合手术治疗HSKTB的可行性。分享此类经验可改善针对这种罕见疾病的临床决策。
