American Journal of Infectious Diseases and Microbiology
ISSN (Print): 2328-4056 ISSN (Online): 2328-4064 Website: Editor-in-chief: Maysaa El Sayed Zaki
Open Access
Journal Browser
American Journal of Infectious Diseases and Microbiology. 2014, 2(3), 48-50
DOI: 10.12691/ajidm-2-3-2
Open AccessLetter To Editor

Pulmonary Tuberculosis Disseminating and Presenting as Bilateral Hydronephrosis and Renal Abscess: a Potential Threat in the Era of Multi-Drug Resistant Tuberculosis MDR-TB

K V Ramana1,

1Department of Microbiology, Prathima Institute of Medical Sciences, Karimnagar, Andhrapradesh, India

Pub. Date: July 01, 2014

Cite this paper:
K V Ramana. Pulmonary Tuberculosis Disseminating and Presenting as Bilateral Hydronephrosis and Renal Abscess: a Potential Threat in the Era of Multi-Drug Resistant Tuberculosis MDR-TB. American Journal of Infectious Diseases and Microbiology. 2014; 2(3):48-50. doi: 10.12691/ajidm-2-3-2


Mycobacterium tuberculosis, the causative agent of tuberculosis was discovered by Robert Koch in 1882. It has been observed that 30% of the world population harbours Mycobacterium tuberculosis. Spread of Human immunodeficiency virus (HIV) infection, malignancies, globalization and malnutrition are some of the major contributing factors for increase in the global burden of tuberculosis (pulmonary and extra-pulmonary TB). Dissemination/spread of tubercle bacilli from the lungs to other organs of the body either through blood or lymphatic circulation results in extra-pulmonary tuberculosis. Immunodeficiency, either due to HIV infection or malignancies, malnutrition and inadequate treatment for pulmonary TB may be considered as some of the predisposing factors for disseminated/miliary TB. It has also been noted that most cases of extra-pulmonary TB are diagnosed accidentally and after a long period of time (months to years) since recovering from pulmonary TB. In the era of Multi-drug resistant tuberculosis (MDR-TB), extremely drug resistant tuberculosis (XDR-TB) and increase in the incidences of disseminated/extra-pulmonary tuberculosis poses a challenge to the medical personnel. Among the extra-pulmonary cases of tuberculosis genitourinary tuberculosis (GUTB) appears to be most frequent as evidenced by the available literature.

Mycobacterium tuberculosis extra-pulmonary tuberculosis genitourinary tuberculosis (GUTB)

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Global Tuberculosis Report, 2013. accessed on 28 January 2014.
[2]  Rom WN, Garay S. Tuberculosis, W.B Saunders. USA. 2000; 47: 609-16.
[3]  Leite OHM. Tuberculosis. Probl. Gen. Surg. 2001; 18: 68-78
[4]  Andre Avarese Figueiredo, Antonio Marmo Lucon, Renato Falci Junior and Miguel Srougi. Epidemiology of urogenital tuberculosis worldwide. International Journal of Urology 2008; 15: 827-832.
[5]  Gow JG. Genitourinary tuberculosis. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds). Campbellā€™s urology. V.1, 7a edn. W. B Saunders company Philadelphia, PA, 1998; 807-836.
[6]  Schubert GE, Haltaufderheide T, Golz R. Frequency of urogenital tuberculosis in an unselected autopsy series from 1928 to 1949 and 1976 to 1989. Eur. Urol. 1992; 21: 216-223.
[7]  Wise GJ. Genitourinary tuberculosis: modern issues. Curr Urol Rep 2009; 10: 313-8.
[8]  Smita Chandra, Harish Chandra, Neena Chauhan, Dushyant Singh Gaur, Harendra Gupta, Ved Prakash Pathak and sandeep Kumar Burathoki. Male genitourinary tuberculosis-13 years experience at a tertiary care center in India. Southeast Asian J Trop Med Public Health 2012; 43 (2): 364-369.
[9]  Figueiredo AA and Lucon AM. Urogenital tuberculosis: Update and review of 8,961 cases from the world literature. Rev Urol 2008; 10: 207-217.
[10]  Das P, Ahuja A, Gupta SD. Incidence, etiopathogenesis and pathological aspects of genitourinary tuberculosis in India: A journey revisited. Indian J Urol 2008; 24; 356-361.
[11]  Matsumura N, Yamamoto K, Hirohashi R, Kitano S. Renal tuberculosis mimicking hydronephrosis. Intern Med 2005; 44 (7): 768.
[12]  Bernaschina CP, Cabrera M, Cardona P, Colon B. Genitourinary tuberculosis: the importance of early diagnosis and management. Bol Asoc Med P R 1994; 86 (10-12): 75-80.
[13]  Muttarak M, ChiangMai WN, Lojanapiwat B. Tuberculosis of the genitourinary tract: imaging features with pathological correlation. Singapore Med J 2005; 46 (10): 568-74; quiz 575.
[14]  Velayati AA, Masjedi MR, Tabatabaee SJ, Zia-Zarifi A. Clinical Tuberculosis. 1st. edition. 1994; 181-219.
[15]  Trasca E, Trasca ET, Buzulica R, Dragoi G, Nicolescu I. The place and the role of histological examination in diagnostic algorithm of urinary system tuberculosis. Rom J Morphol Embryol 2005; 46 (2): 105-8.
[16]  Centers for Disease Control and Prevention. Reported tuberculosis in the United states, 1999, 2000, and 2001. [cited 2014 June 2] Availabe at
[17]  Gonzalez OY, Adams G, Teeter LD, Bui TT, Musser JM, Graviss EA. Extra-pulmonary manifestations in a large metropolitan area with a low incidence of tuberculosis. Int J Tuberc Lung Dis. 2003;7: 1178-85.