Tubercular Pyonephrosis without Lymphadenitis: A Rare Case Report with Review of Literature
Year: 2024
Type: article
Study design: Case Report
Abstract: required nephrectomy, along with a review of the literature on tubercular pyelitis, pyelonephritis, and pyonephrosis. Case DesCriptionA 37-year-old male presented to the outpatient department of a private hospital with complaints of pain and burning micturition, accompanied by intermittent fever persisting for 1 week.He had also experienced urinary incontinence 2 weeks prior to his visit.The patient had an unremarkable medical history with no significant family history or underlying health conditions.Laboratory investigations, including complete blood count, liver function tests, renal function tests, and electrolyte levels, all returned with normal results.Routine X-ray revealed no lung lesions.No lymphadenopathy was detected. introDuCtionTuberculosis, caused by Mycobacterium tuberculosis, has been a longstanding global health challenge, ranking among the top 10 causes of death.According to the World Health Organization's (WHO) global tuberculosis report released in November 2023, an estimated 10.6 million new infections and 1.3 million tuberculosis-related deaths were reported worldwide.India alone accounted for 27% of all tuberculosis cases globally, with a case fatality ratio of 12%. 1 While pulmonary tuberculosis remains the most prevalent form, an increasing number of patients are now reporting extrapulmonary involvement, affecting up to 45% of patients.2 Genitourinary tuberculosis (GUTB), including infections of the kidney, testis, and prostate was first documented by G L Bayle in 1810.Today, it stands as the second most common type of extrapulmonary tuberculosis, after tubercular lymphadenitis with >90% of cases occurring in developing countries.2 GUTB primarily involves the kidneys which may be either due to hematogenous spread from a disseminated disease, or from a localized genitourinary disease.Pyelitis and pyelonephritis are typically caused by bacterial infections, which lead to the inflammation of the kidneys.It usually arises as a complication of a urinary tract infection (UTI) that ascends from the bladder to the kidneys.3 Pyonephrosis occurs as a serious complication of pyelonephritis, characterized by the accumulation of pus in the pelvicalyceal system.This condition can result in sepsis and significant loss of renal function.4 During an extensive literature review, only a handful of cases of tubercular pyelonephritis and pyonephrosis were identified, indicating a lack of research on these conditions.Notably, there are no reported cases of tubercular pyelitis in the literature.Here, we present a case of tubercular pyonephrosis that was diagnosed late due to the patient's delayed presentation, which ultimately 1,
Authors: Mahamaya Sharma, Neda Ahsan, Santanu Singh
Institution: South Eastern Railway
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404530861