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Chapter 22 : Urogenital Tuberculosis

Authors: André A. Figueiredo1, Antônio M. Lucon2, Miguel Srougi3
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Affiliations: 1: Núcleo Interdisciplinar de Pesquisa em Urologia and Department of Surgery/Urology, Federal University of Juiz de Fora, Minas Gerais—Brazil; 2: Division of Urology, University of São Paulo Medical School, São Paulo, Brazil; 3: Division of Urology, University of São Paulo Medical School, São Paulo, Brazil
Content Type: Monograph
Publication Year: 2017

Category: Bacterial Pathogenesis; Clinical Microbiology

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Abstract:

Tuberculosis has a worldwide distribution, without cyclical or seasonal variations and with greater prevalence in regions of high population densities and poor socioeconomic and sanitary status. It is estimated that 30% of the world’s population (1.7 billion people) are carriers of ( ). In spite of the availability of pharmacological treatment and of technological breakthroughs, the last 3 decades have witnessed a recrudescence of the infection due to the emergence of resistant bacilli, human migration, and the AIDS epidemic. In fact, tuberculosis is still a serious challenge to the world public health, chiefly in developing countries ( ).

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Urogenital Tuberculosis
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Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
/content/10.1128/9781555819866.chap22.fig22-1
Figure 1

Post-contrast phase of abdominal computed tomography (CT) in an AIDS patient, with bilateral renal abscesses and dilatation of the collecting system on the right. Retroperitoneal lymph node enlargement with central necrosis is apparent (arrow). From reference , with permission.

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Image of Figure 1
Figure 1

Post-contrast phase of abdominal computed tomography (CT) in an AIDS patient, with bilateral renal abscesses and dilatation of the collecting system on the right. Retroperitoneal lymph node enlargement with central necrosis is apparent (arrow). From reference , with permission.

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Figure 2

Magnetic resonance imaging (A) and CT (B and C) of patients with unilateral renal tuberculosis, with dilatation of the collecting system (caliectasis) and thinning of the renal parenchyma. There is no dilatation of the renal pelvis. From reference , with permission.

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Figure 2

Magnetic resonance imaging (A) and CT (B and C) of patients with unilateral renal tuberculosis, with dilatation of the collecting system (caliectasis) and thinning of the renal parenchyma. There is no dilatation of the renal pelvis. From reference , with permission.

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Figure 3

Sequential exams of patient with urogenital tuberculosis. (A) Initial intravenous urography (IU) with right kidney dysfunction and normal left kidney and bladder. (B) IU after 10 months, with development of contracted bladder and ureterohydronephrosis on the left. (C) Voiding cystography showing high-grade vesicoureteral reflux on the left as a cause of dilatation of the collecting system. From reference , with permission.

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Image of Figure 3
Figure 3

Sequential exams of patient with urogenital tuberculosis. (A) Initial intravenous urography (IU) with right kidney dysfunction and normal left kidney and bladder. (B) IU after 10 months, with development of contracted bladder and ureterohydronephrosis on the left. (C) Voiding cystography showing high-grade vesicoureteral reflux on the left as a cause of dilatation of the collecting system. From reference , with permission.

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Figure 4

Sequential exams of a patient with urogenital tuberculosis. (A) Initial IU with normal right kidney and left kidney with ureterohydronephrosis due to stenosis of the middle ureter (arrow) and intrarenal stenoses without pelvic dilatation (typical tuberculosis feature). (B) Cystography with normal bladder and no reflux. (C and D) IU and voiding cystography after 6 months without treatment, showing renal dysfunction on the left and ureterohydronephrosis on the right, with contracted bladder and bilateral vesicoureteral reflux (high grade on the right) as a cause of ureterohydronephrosis. From reference , with permission.

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10.1128/9781555819866/fig22-4.gif
Image of Figure 4
Figure 4

Sequential exams of a patient with urogenital tuberculosis. (A) Initial IU with normal right kidney and left kidney with ureterohydronephrosis due to stenosis of the middle ureter (arrow) and intrarenal stenoses without pelvic dilatation (typical tuberculosis feature). (B) Cystography with normal bladder and no reflux. (C and D) IU and voiding cystography after 6 months without treatment, showing renal dysfunction on the left and ureterohydronephrosis on the right, with contracted bladder and bilateral vesicoureteral reflux (high grade on the right) as a cause of ureterohydronephrosis. From reference , with permission.

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Figure 5

Voiding urethrocystography showing contracted bladder, no vesicoureteral reflux, and prostate tuberculosis, with dilatation and irregularities of the prostatic urethra. From reference , with permission.

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Image of Figure 5
Figure 5

Voiding urethrocystography showing contracted bladder, no vesicoureteral reflux, and prostate tuberculosis, with dilatation and irregularities of the prostatic urethra. From reference , with permission.

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
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Tables

Urogenital Tuberculosis
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Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
/content/10.1128/9781555819866.chap22.tab22-1
Table 1

Frequency of affected urogenital organs

Generic image for table
Table 1

Frequency of affected urogenital organs

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
/content/10.1128/9781555819866.chap22.tab22-2
Table 2

Comparison of patients from developed and developing countries

Generic image for table
Table 2

Comparison of patients from developed and developing countries

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016
/content/10.1128/9781555819866.chap22.tab22-3
Table 3

Features of immunocompromised and nonimmunocompromised patients with urogenital tuberculosis

Generic image for table
Table 3

Features of immunocompromised and nonimmunocompromised patients with urogenital tuberculosis

Citation: Figueiredo A, Lucon A, Srougi M. 2017. Urogenital Tuberculosis, p 355-370. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0015-2016

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