Cases reported "Tuberculosis, Renal"

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1/7. Renal tuberculosis mimicking xanthogranulomatous pyelonephritis: ultrasonography, computed tomography and magnetic resonance imaging findings.

    The incidence of tuberculosis has been increasing in recent years, and its treatment has also become challenging. The diagnosis of renal tuberculosis is often difficult and delayed. Early and correct diagnosis of tuberculosis with different organ system involvement is very important and can be easier with ultrasonography, computed tomography and/or magnetic resonance imaging. Although renal tuberculosis is the result of hematogenous spread more commonly from the lungs, less than 5%, of patients with urinary tract tuberculosis have active pulmonary disease. Renal tuberculosis may show variable radiological findings depending on the stage of the infection. Although an end-stage "autonephrectomized" kidey in tuberculosis is classically defined to be small in size, enlargement may on rare occasions be observed, which is the case in our patient. This form greatly mimics diffuse xanthogronulomatous pyelonephritis. Both diseases show thickening of the perirenal fasciae and spread of inflammation into the adjacent organs. Computed tomography and magnetic resonance imaging may show some specific features to differentiate these two entities.
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2/7. Tuberculosis of the greater trochanteric bursa occurring 51 years after tuberculous nephritis.

    We present a case of tuberculous greater trochanteric bursitis occurring 51 years after tuberculous nephritis in a 71-year-old man. Radiographs of the affected hip revealed focal osteolysis of the greater trochanter and calcification in the surrounding soft tissues. Contrast-enhanced CT scans and MRI revealed that the enlarged bursa extended into the femoral intermuscular spaces. Bacterial culture of the biopsied bursa grew mycobacterium tuberculosis. Total excision of the infected bursa, combined with antituberculous therapy, was curative. Tuberculosis of the greater trochanteric bursa should be included in the differential diagnosis of chronic hip pain. New tuberculous musculoskeletal lesions can occur elsewhere in the body many years after primary tuberculous lesions have healed.
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3/7. Pseudotuberculous pyelonephritis associated with nephrolithiasis.

    This report describes a 40-year-old man with an unusual form of granulomatous pyelonephritis, associated with nephrolithiasis, resulting in end-stage kidney disease and right pretransplant nephrectomy. The kidney specimen contained a staghorn calculus and showed chronic inflammation with confluent caseating granulomas and multinucleated giant cells, resembling renal tuberculosis. However, neither tubercle bacilli nor other microorganisms were demonstrated in the renal tissue or in urine cultures. Because these findings do not support a tuberculous etiology of the granulomatous pyelonephritis, we conclude that this patient had a pseudotuberculous reaction as a consequence of nephrolithiasis.
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4/7. Renal tuberculosis simulating xanthogranulomatous pyelonephritis with contagious hepatic involvement.

    Xanthogranulomatous pyelonephritis (XGPN) is a chronic renal infection typically associated with nephrolithiasis and a non-functioning kidney. Renal tuberculosis is a major cause of morbidity in developing countries. Despite recent advances in diagnosis, it is sometimes difficult to differentiate renal tuberculosis preoperatively from XGPN. We present herewith a case report of a patient who was preoperatively diagnosed with a right non-functioning kidney due to renal calculus with stage 3 XGPN and adjacent liver abscess on computed tomography. Subsequent histopathological examination of the nephrectomised specimen revealed renal tuberculosis. To our knowledge this is the first case of renal tuberculosis spreading to the liver and causing liver abscess formation which was misdiagnosed as XGPN preoperatively.
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5/7. Papillary necrosis associated with rifampicin therapy.

    We report a patient who developed progressive renal failure following 13 months of rifampicin therapy for renal tuberculosis. The renal function continued to deteriorate despite the discontinuation of rifampicin. Renal pathology did not demonstrate any evidence of tuberculosis of the kidney but revealed the unique pathological finding of glomerulosclerosis, granulomatous interstitial nephritis, and extensive papillary necrosis.
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6/7. citrobacter emphysematous pyelonephritis in a tuberculous kidney caused by citrobacter. A case report in a diabetic patient.

    Emphysematous pyelonephritis caused by gas-producing bacteria like escherichia coli or klebsiella pneumonia is generally observed in female diabetic patients. We report a case in which citrobacter was the microbiologically documented pathogen. High-dose antibiotic regimen was administered, but nephrectomy was necessary to overcome the life-threatening situation.
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7/7. Granulomatous interstitial nephritis in renal transplant recipient.

    Tuberculosis of a transplanted kidney is a rare and serious complication. Search for renal tuberculosis as the cause of deterioration of graft function is mandatory in a renal transplant recipient with tuberculosis of other organs e.g. pulmonary tuberculosis in this patient. Renal histopathology is required for the diagnosis. Treatment with anti-tuberculosis drugs can improve renal function. drug interactions should be considered when rifampicin is administered with cyclosporin A.
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