Tuberculous pyelonephritis in children: three case reports

Autor:	Nimisha Arora, Manpreet Kaur, Abhijeet Saha
Rok vydání:	2017
Předmět:	Male Flank Pediatrics medicine.medical_specialty media_common.quotation_subject Biopsy Fine-Needle Antitubercular Agents 030232 urology & nephrology Tuberculosis Lymph Node Urine Kidney Function Tests Nephrectomy 03 medical and health sciences 0302 clinical medicine Pulmonary tuberculosis Humans Medicine Tuberculosis Renal Girl Child Skin Tests Ultrasonography media_common Pyelonephritis business.industry Tuberculous pyelonephritis Mycobacterium tuberculosis Treatment Outcome 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Female Radiography Thoracic Tomography X-Ray Computed business
Zdroj:	Paediatrics and International Child Health. 37:292-297
ISSN:	2046-9055 2046-9047
DOI:	10.1080/20469047.2017.1386847
Popis:	Tuberculous pyelonephritis is rare in children; three case reports are presented. Case 1 was an 11-year-old girl with a previous history of pulmonary tuberculosis who presented with flank pain and fever for 10 days. An ultrasound suggested focal pyelonephritis, and a contrast-enhanced computed tomography (CECT) scan demonstrated acute focal pyelonephritis and a perinephric collection. Mycobacterium tuberculosis was cultured in the urine. She responded well to anti-tuberculous treatment (ATT). Case 2 was a 13-year-old boy who presented with fever, haematuria, burning micturition, proteinuria (3+) and cervical lymphadenopathy. The Mantoux test was strongly positive. Chest radiograph demonstrated right hilar lymphadenopathy and ultrasonography showed evidence of acute pyelonephritis. Tuberculous lymphadenitis was diagnosed by fine-needle aspiration cytology (FNAC) from cervical lymph nodes and he responded to ATT. Follow-up urinalysis and ultrasound were normal. Case 3 was a 6-year-old boy, a known case of pulmonary tuberculosis (from 2 years of age) and a previous defaulter from ATT. He presented with symptoms of lumbar pain and dysuria. Chest radiograph demonstrated mediastinal lymphadenopathy and a CECT of the head showed a tuberculous granuloma. CECT of the abdomen showed an enlarged left kidney with focal pyelonephritis, an abscess in the upper pole and parenchymal calcification. FNAC of the cervical lymph nodes supported a diagnosis of disseminated tuberculosis with tuberculous pyelonephritis. He was given 8 months of ATT. Fifteen months later he presented again with clinical and urinary findings of urinary tract infection. CECT now demonstrated gross hydronephrosis of the left kidney, and it was confirmed to be non-functioning by a DMSA scan and magnetic resonance urogram. Diethylenetriaminepentaacetic acid showed a GFR of 44.3 ml/min/1.73 m
Databáze:	OpenAIRE
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