Tuberculosis renal

Abstract

The present degree work, focused on the study and analysis of a clinical case of a 72-year-old female patient, with a history of urinary tract infection repeated for a year, who went to the urology clinic for presenting low back pain, polaquiuria, unquantified fever and blood urine. On physical examination: the normal vital signs, the positive: painful abdomen on palpation in hypogastrium, upper anterior ureteral points are positive and bilateral positive punching. The differential diagnosis was made based on the clinic with: renal lithiasis, pyelonephritis, renal cancer, lupus nephritis, syphilis and renal tuberculosis. Laboratory tests revealed: blood count with slightly decreased hemoglobin, and non-reactive HIV and VDRL. The general urine test showed: sterile pyria, hematuria and acid urine, urine smears and cultures were positive and the histopathological study indicated granulomatous lesions. In addition, a calcified granuloma was found on the chest radiograph, Urotac reported: images compatible with tuberculosis infection bilaterally, left mastic kidney and inflammatory signs of the bladder wall. The final diagnosis of: renal tuberculosis, renal lithiasis and mild anemia is obtained through clinical criteria and complementary examinations. As a pharmacological treatment: rifampicin, isoniazid, ethambutol and pyrazinamide were administered for two months, followed by isoniazid and rimfampicin for four months. Additional surgical interventions were performed such as: right double J catheter placement due to ureteral stenosis, left laparoscopic nephrectomy due to mastic kidney and right percutaneous nephrolithotomy due to renal lithiasis. At the moment the patient has a good recovery and is stable. Renal tuberculosis is a common disease in our environment, so it is important to know about this condition, to be able to suspect it, diagnose it in time and establish an effective treatment thus avoiding future complications.