Genito-urinary TB Flashcards
1
Q
Pathogenesis
A
Primary infection of lung/bowel➡️lymphatics ➡️ haematog to bones and joints, meninges, Genito-urinary renal cortex, head of epididymis and prostate➡️ dormant…. Lowered immunity ➡️ reactivation. Transluminal spread.
2
Q
Presentation
A
Young adults Past hx or fam hx Cystitis not responding to antibiotics Haematuria Flank pain due to stricture➡️ hydronephrosis Renal failure Systemic symptoms
3
Q
Special investigations
A
Urine: sterile acid pyuria, 20% have E. coli UTI, 3x early morning samples for MC&S and Ziel Neelsen staining, culture Renal function tests ESR gen not elevated in uro TB CXR EUG abnormal in 80% of uro TB, parenchymal calcifications, papillary necrosis (DM, algae sic abuse, sickle cell, recurrent pyelonephritis) cavities in renal parenchyma, strictures, poor or non functioning kidney, small bladder capacity. CT US Radioisotope renogram Cystoscope and bladder biopsy
4
Q
Stats of Genito TB
A
1% in devel countries in old people vs. 15-20% in developing with young 20-40
Kidney = commonest site, 30% have only genital
