Genitourinary TB

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[edit] Genitourinary TB

As the kidney is a very vascular organ, TB bacteria often get trapped in the kidney where they can lay dormant for years. Then, when the immune system is weakened, these foci can suddenly get activated and destroy large parts of a kidney.

The renal pelvis is prone to get TB infected and a tuberculous pyelonephritis develops, which erroneously is "sterile" on routine cultures. TB cultures or testing with the commercially available polymerase chain reaction to TB would show the tuberculous infection.

Typically the infection spreads to the bladder, and in men to the prostate gland, the seminal vessels and the epididymis.

This is palpable as a scrotal mass. In young women where the fallopian tubes are very vascular an initial primary TB of the lung may migrate via the blood stream to the ovaries and fallopian tubes. This leads to scarring in the tubes and possible ectopic pregnancies or sterility. On the other hand there may be a pelvic mass requiring a diagnostic workup. Initially laparoscopy is done, but because of the complexity of the disease eventually a laparotomy may be required.

Infections overview

Respiratory infections

Tuberculosis table

References:

1. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 161.

2. TC Dixon et al. N Engl J Med 1999 Sep 9;341(11):815-826.

3. F Charatan BMJ 2000 Oct 21;321(7267):980.

4. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 43.

5. JR Zunt and CM Marra Neurol Clinics Vol.17, No.4,1999: 675-689.

6. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 162.

7. LE Chapman : Antivir Ther 1999; 4(4): 211-19.

8. HW Cho: Vaccine 1999 Jun 4; 17(20-21): 2569-2575.