Renal Tuberculosis, the Great Mimicker: From Recurrent Urinary Tract Infection to Nephrectomy
Keywords:
Renal Tuberculosis, Recurrent Urinary Tract Infection, TB Mimick
Abstract
Extra-pulmonary tuberculosis is more common in immunocompromised patients such as HIV, uncontrolled diabetes mellitus, patients on immunosuppressants, children <15 years old and elderly individuals above the age of 65. Urogenital TB occurs in 2-20% of individuals with pulmonary TB (1). It is frequently misdiagnosed due to a lack of awareness among clinicians, non-specific symptoms and slow progression of disease. A low threshold for investigation towards genitourinary TB is needed in patients who are immunosuppressed and present with recurrent urinary tract infection despite being on a standard antibiotic regimen. Prompt treatment is warranted in such patients. In this case report, we will discuss a case of renal TB which was diagnosed late and resulted in devastating complications.
References
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11. Dowdy DW, Lourenço MC, Cavalcante SC, Saraceni V, King B, et al. Impact and cost-effectiveness of culture for diagnosis of tuberculosis in HIV-infected Brazilian adults. PloS One. 2008;3:e4057. doi: https://doi.org/10.1371/journal.pone.0004057
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14. Wejse C. Medical treatment for urogenital tuberculosis (UGTB). GMS Infect Dis. 2018 Aug 9;6:Doc04. doi: https://doi.org/10.3205/id000039
2. Roddy K, Tobin EH, Leslie SW, Ratfish B. Genitourinary Tuberculosis. 2024 Aug; https://pubmed.ncbi.nlm.nih.gov/32491490/
3. Figueiredo AA, Lucon AM. Urogenital Tuberculosis: Update and Review of 8961 Cases from the World Literature. Reviews in Urology. 2024 Aug;10(3):207–217. https://pmc.ncbi.nlm.nih.gov/articles/PMC2556487/
4. Nor Z, Nazari MJ. Hydronephrosis secondary to isolated renal tuberculosis in an immunocompetent adolescent: “A case report.” Urology Case Reports. 2024 Nov;57. doi: https://doi.org/10.1016/J.EUCR.2024.102876
5. Muneer, A., Macrae, B., Krishnamoorthy, S. et al. Urogenital tuberculosis — epidemiology, pathogenesis and clinical features. Nat Rev Urol 16, 573–598 (2019). doi: https://doi.org/10.1038/s41585-019-0228-9
6. Tuberculosis of the genitourinary system: urinary tract tuberculosis: renal tuberculosis-part I. Merchant S, Bharati A, Merchant N. Indian J Radiol Imaging. 2013;23:46–63. doi: doi: https://doi.org/10.4103/0971-3026.113615
7. Atherton RR, Cresswell FV, Ellis J, Skipper C, Tadeo KK, Mugumya G, Wadda V, Meya DB, Boulware DR. Detection of Mycobacterium tuberculosis in urine by Xpert MTB/RIF Ultra: A useful adjunctive diagnostic tool in HIV-associated tuberculosis. Int J Infect Dis. 2018; doi: https://doi.org/10.1016/j.ijid.2018.07.007
8. Bausch K, Mantica G, Smith EJ, Bartoletti R, Bruyère F, Cai T, Geerlings S, Kranz J, Köves B, Pilatz A, Schubert S, Veeratterapillay R, Wagenlehner F, Gupta N, Bonkat G. Genitourinary Tuberculosis: A Brief Manual for Urologists on Diagnosis and Treatment from the European Association of Urology Urological Infections Panel. Eur Urol Focus. 2024 Jan;10(1):77-79. doi: https://doi.org/10.1016/j.euf.2023.07.006
9. Ministry of Health Malaysia. Management of Tuberculosis. 4th ed. Putrajaya: Malaysian Health Technology Assesment Section; 2021; https://www.moh.gov.my/images/04-penerbitan/penerbitan-klinikal/panduan-amalan-klinikal/CPG-_Management_of_Tuberculosis_4th_Edition.pdf
10. Hanna BA, Ebrahimzadeh A, Elliott LB, Morgan MA, Novak SM, et al. Multicenter evaluation of the BACTEC MGIT 960 system for recovery of mycobacteria. J Clin Microbiol. 1999;37:748–752. doi: https://doi.org/10.1128/JCM.37.3.748-752.1999
11. Dowdy DW, Lourenço MC, Cavalcante SC, Saraceni V, King B, et al. Impact and cost-effectiveness of culture for diagnosis of tuberculosis in HIV-infected Brazilian adults. PloS One. 2008;3:e4057. doi: https://doi.org/10.1371/journal.pone.0004057
12. Amukotuwa s, Niknejad M, Luitel S, et al. Renal tuberculosis. Reference article, Radiopaedia.org (Accessed on 18 Mar 2025); https://doi.org/10.53347/rID-1973
13. Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, Drobniewski F, Lalvani A. A systematic review of rapid diagnostic tests for the detection of tuberculosis infection. Health Technol Assess. 2007 Jan;11(3):1-196. doi: https://doi.org/10.3310/hta11030
14. Wejse C. Medical treatment for urogenital tuberculosis (UGTB). GMS Infect Dis. 2018 Aug 9;6:Doc04. doi: https://doi.org/10.3205/id000039
Published
2026-01-21
How to Cite
A/L V J Kumaran, D. Y. K., Radhakrishnan, D. A. A. P., & Mohd Thabit, D. A. A. B. (2026). Renal Tuberculosis, the Great Mimicker: From Recurrent Urinary Tract Infection to Nephrectomy. International Research in Medical and Health Sciences, 8(5), 13-17. Retrieved from https://www.irmhs.com/index.php/irmhs/article/view/239
Section
Articles
