1/59. New aspects of urinary tuberculosis. In urinary tuberculosis, during recent years, there has been remarkable progress in treatment but some new aspects are reported, which raise problems in diagnosis and therapeutics. There is an increase of silent forms, forms with rapid destructive development, even under treatment, and forms masked by association with other diseases. The percentage of elderly patients has increased, as has the number of cases presenting with advanced lesions with little clinical manifestation. This calls for more careful searching, assessment and survey of any suspected case. ( info) |
2/59. Urachal tuberculosis. BACKGROUND: We report on an extremely rare case of urachal tuberculosis that was confirmed using a polymerase chain reaction test of paraffin-embedded material. methods/RESULTS: A 62-year-old man presented with pollakiuria. With a diagnosis of urachal abscess, the patient underwent en bloc resection of the cystic mass. A bacterial culture test of the content showed no organism. The histopathologic findings suggested urachal tuberculosis. The AMPLICOR polymerase chain reaction test by using paraffin-embedded sections revealed the existence of Mycobacterium tuberculosis in the resected tissue. The only positive finding in systemic screening examinations for tuberculosis was old tuberculosis scars in the upper right lung. It was supposed that hematogeneous spreading from the lung lesion may result in urachal tuberculosis after a long latent period. CONCLUSIONS: Although urachal tuberculosis is an extremely rare condition, tuberculosis must always be kept in mind when observing any infectious diseases. ( info) |
3/59. Genitourinary tuberculosis after renal transplantation: report of 3 cases and review. mycobacterium tuberculosis infection of the genitourinary tract is an uncommon disease in renal transplant recipients and presentation is atypical. Genitourinary tuberculosis is associated with graft rejection, and this diagnosis should be considered for renal transplant recipients with unexplained fever and constitutional symptoms. ( info) |
| A 50 year old heterosexual male presented with fever and cough with expectoration of months duration, and swelling in the right testis. The serological tests showed positivity for hiv 1 and 11 antibodies. Testicular biopsy from the right testis showed epitheloid cell granulomas with central caseous necrosis and peripheral mantle of lymphocytes and plasma cells. Zeihl-Neelsen stain on tissue sections showed AFB positivity. To the best of our knowledge this is the second reported case of acquired immunodeficiency syndrome presenting as testicular tuberculosis. ( info) |
5/59. Tuberculous meningitis associated with urinary tract tuberculosis. The association of tuberculous meningitis (TBM) and urinary tract tuberculosis is very rare. Two cases of this condition are reported. Both presented with subacute to chronic meningitis with lymphocytic pleocytosis, elevation of protein content and depression of glucose level of cerebrospinal fluid. pyuria and hematuria were detected and Ziehl-Neelsen's stain was positive for acid fast bacilli (AFB). Urographic abnormalities were compatible with urinary tract tuberculosis. AFB smear of urine is the simplest method to detect urinary tract tuberculosis. ( info) |
6/59. Tuberculous ureteric stricture. The management of a young woman with a ureteric stricture is a challenge to the urologist. Genitourinary tuberculosis can cause ureteric strictures, with minimal symptoms. Untreated, it can lead to impairment of renal function. diagnosis of genitourinary tuberculosis may be delayed until histopathological assessment. Drug treatment and reconstructive surgery produce good results. ( info) |
7/59. Abdominal pregnancy complicated by genital and renal tuberculosts and hemolytic anemia. After a 10-year period of primary infertility, a patient presented with abdominal pregnancy. Known to have had previously treated genital tuberculosis, on admission she was found to have renal tuberculosis and autoimmune hemolytic anemia. After fetal death, laparotomy was performed and the fetus was removed. The patient's anemia responded well to steroid therapy and she was discharged on antituberculous triple therapy. The literature on hemolytic anemia in pregnancy and in association with tuberculosis, as well as on ectopic gestations, was reviewed. ( info) |
8/59. Recent changes in the assessment of urogenital tuberculosis. The urogenital tuberculosis has undergone a change in form and clinical assessment. The absolute proportion of urogenital tuberculosis cases has fallen off sharply since 1967. The nmber of surgical interventions is also remarkably reduced. The cases exhibiting a milder stage have significantly increased, while the severe cases have decreased. This change of tuberculosis has made a conservative therapy favorable; therefore the current operative indication is somewhat different than 15 years ago. The time of release from the stationary treatment depends first on the animal experiment and bacterial findings; furthermore, tests are necessary to determine the status of immunity. It was revealed with urogenital tuberculosis, through regular examination of the menstrual blood of women, that the number of positive cases among women was considerably higher, than among men. In contracted bladder a surgical intervention is often necessary due to intense pain and incontinence. We prefer the rectal bladder with sigmoid pull-through inside the sphincter ani, whereby excellent success can be achieved. The study shows that the clinical assessment of tuberculosis is somewhat different today than is was earlier. Tuberculosis underwent a change in form that must be taken into consideration with respect to operative indication. ( info) |
9/59. Genitourinary tuberculosis: study of 20 patients. In the past year 20 new cases of genitourinary tuberculosis were referred for treatment at Wrightington Hospital. Many of these patients had waited a long time between diagnosis and referral and the start of effective treatment. We suggest that a new short course of chemotherapy should be used, and surgery undertaken during the first three months of treatment, but after the patient has had at least four weeks' drug treatment. After chemotherapy follow-up may be reduced to two years. Genitourinary tuberculosis remains a serious disease and should be managed by a urologist. ( info) |
10/59. Primary urethral tuberculosis masquerading as a urethral caruncle: a diagnostic curiosity! Primary urethral tuberculosis associated with a caruncle is an extremely rare entity and ours is the second such case to be reported. A middle-aged woman presented with symptoms of frequency dysuria syndrome for the last 2 years. Local examination and cystoscopy revealed localized parurethral induration, tenderness and a urethral caruncle with chronic obliterative urethritis. Transvaginal ultrasound revealed a solid lesion arising from the posterior urethral wall. Excision of the caruncle and transurethral resection of the paraurethral mass lesion revealed chronic granulomatous inflammation with chronic urethritis and fibrocollagenous tissue. The literature regarding the genesis of urethral caruncle, the underlying conditions, its differential diagnosis and management has been reviewed. ( info) |