Abera Adane Alemayehu, Mamuye Meseret Adugna, Ferede Yibeltal Alamir, Fentaye Sirak Mekonnen, Tsefamaryam Behaylu Hagos, Ayen Addisu Assfaw
Department of Internals Medicine, Debre Berhan university, Debre Berhan, Ethiopia.
Department of Internal Medicine, Bahir Dar University, Bahir Dar, Ethiopia.
Ann Med Surg (Lond). 2025 Jul 16;87(8):5311-5315. doi: 10.1097/MS9.0000000000003576. eCollection 2025 Aug.
TB, a major health concern caused by Mycobacterium tuberculosis, primarily affects the lungs but can also manifest as extrapulmonary TB (EPTB). Genitourinary tuberculosis (GUTB) ranks third among extrapulmonary TB cases, following lymphatic and pleural involvement.
A 45-year-old female from Amahra, Ethiopia presented with long-standing flank pain, constitutional symptoms, and lower urinary tract symptoms. She had no significant comorbidities. Physical examination was unremarkable except for left costovertebral angle tenderness. Abdominal imaging revealed normal renal parenchyma, left hydronephrosis, and a staghorn calculus. A unilateral nephrectomy was performed, and surprisingly, pathological analysis suggested renal tuberculosis. The patient was subsequently treated with a 6-month course of antituberculosis therapy.
Isolated renal tuberculosis (RTB) is a rare and often difficult-to-diagnose form of TB due to its nonspecific symptoms. Presentations range from asymptomatic to severe, including complications like staghorn calculi or masses. Rena; TB, while typically associated with certain risk factors, can occur even in their absence, as in this case where the patient only resided in a high TB burden area. Mycobacterium tuberculosis usually reaches the kidneys via hematogenous spread from the lungs, though direct spread is also possible, but isolated renal involvement is rare. Diagnosis of isolated renal tuberculosis is challenging, often requiring histopathology after nephrectomy or biopsy, as urine cultures may be unrevealing. Imaging findings vary with the disease stage, with CT best for calcifications and CT IVP offering broader sensitivity. Treatment involves anti-tuberculosis medications guided by WHO and national guidelines. While medications are often sufficient, advanced cases may require surgical interventions like nephrectomy, with the choice dependent on factors like disease extent and renal function.
Isolated renal tuberculosis (RTB) is rare and can be difficult to diagnose due to its varied symptoms Early detection and treatment with anti-TB drugs are key to preventing irreversible kidney damage and nephrectomy.
结核病是由结核分枝杆菌引起的主要健康问题，主要影响肺部，但也可表现为肺外结核（EPTB）。泌尿生殖系统结核（GUTB）在肺外结核病例中位列第三，仅次于淋巴和胸膜受累情况。
一名来自埃塞俄比亚阿姆哈拉的45岁女性，出现长期胁腹疼痛、全身症状及下尿路症状。她无明显合并症。体格检查除左肋脊角压痛外无异常。腹部影像学检查显示肾实质正常、左肾积水及鹿角形结石。进行了单侧肾切除术，令人惊讶的是，病理分析提示为肾结核。该患者随后接受了为期6个月的抗结核治疗。
孤立性肾结核（RTB）是一种罕见且通常难以诊断的结核病形式，因其症状不具特异性。表现从无症状到严重不等，包括鹿角形结石或肿块等并发症。肾结核虽然通常与某些危险因素相关，但即使没有这些因素也可能发生，如本例患者仅居住在结核病负担高的地区。结核分枝杆菌通常通过血液从肺部传播至肾脏，不过直接传播也有可能，但孤立性肾受累情况罕见。孤立性肾结核的诊断具有挑战性，通常需要在肾切除或活检后进行组织病理学检查，因为尿液培养可能无结果。影像学表现因疾病阶段而异，CT对钙化显示最佳，CT静脉肾盂造影（CT IVP）具有更广泛的敏感性。治疗需遵循世界卫生组织和国家指南使用抗结核药物。虽然药物治疗通常就足够了，但晚期病例可能需要手术干预，如肾切除术，具体选择取决于疾病范围和肾功能等因素。
孤立性肾结核（RTB）罕见，因其症状多样故难以诊断。早期发现并用抗结核药物治疗是预防不可逆转的肾损伤和肾切除术的关键。
